Argument: Enforcing mandates may intrude on Constitutional rights

Issue Report: Constitutionality of US health insurance mandates


Peter Urbanowicz and Dennis G. Smith. “Constitutional implications of an ‘individual mandate'” Federalist Society: “The mechanisms of enforcement of an individual mandate would invite scrutiny as well. Enforcement through the federal tax system would be useless for those who have no income to be taxed and do not file tax returns or for those who have no tax liability. This suggests even more aggressive types of enforcement will be necessary. Sherry Glied, Ph.D., who was recently nominated by President Obama become Assistant Secretary for Planning and Evaluation at the U.S. Department of Health and Human Services has warned, ‘[d]eveloping a system to promptly identify and penalize scofflaws will take effort and ingenuity, particularly in our diverse and mobile country. It may require a degree of intrusiveness and bureaucracy that some will find unpalatable.'” While this does not inherently mean that intrusions will occur against individual rights, enshrined in the Constitutions, it does mean that an insurance mandate does increase the likelihood of intrusions on Constitutional rights.

[…] Currently, individuals without auto insurance are identified during traffic stops by police or when applying for or renewing a driver’s license. Would such “effort, ingenuity, and intrusiveness” require hospitals and doctors to report to the federal government patients without health insurance presenting to their emergency rooms or offices? Or might it inspire enforcement mechanisms employed in child support cases such as the denial of certain government controlled licenses or withholding of tax refunds. As previously noted, the Senate HELP Committee draft bill suggests that insurance companies and employers would be required to file annually with the Internal Revenue Service the equivalent of a Form “W-4” or “1099” and report to the IRS all individuals with health insurance.”