Koster: Federal insurance mandate unconstitutional

JEFFERSON CITY, Mo. -- Breaking months of silence, Missouri's Democratic attorney general asserted Monday that Congress overstepped its constitutional powers when it mandated that most Americans have health insurance or pay a penalty.

Attorney General Chris Koster filed a federal appeals court document in support of a lawsuit brought by Florida and 25 other states challenging the constitutionality of the federal health care law enacted by President Barack Obama last year.

Missouri voters last August became the first in the nation to pass a measure barring the government from requiring people to have health insurance and from penalizing those who don't. It also comes after Missouri's Republican-led House and Senate each passed resolutions urging Koster to defend the new state law and challenge the federal health care law.

Koster said in a letter to legislative leaders Monday that he personally supports an expansion of health coverage but, based on his legal analysis, believes the federal law is in conflict with Missouri's new voter-approved law and goes beyond what courts previously have found to be Congress' authority to regulate interstate commerce under the U.S. Constitution.

At issue is a requirement that Americans carry health insurance except in cases of financial hardship. Those who cannot show they are covered by an employer, government program or their own policy would face IRS fines when the program takes effect in 2014.

U.S. District Judge Roger Vinson of Florida ruled in January that the federal health law was unconstitutional because the individual insurance mandate exceeded congressional authority. Although three other federal judges have upheld the law, Vinson's decision followed the reasoning of a federal judge in Virginia who also ruled against the law. While the Virginia judge left the rest of the law intact, Vinson invalidated the entire thing -- including an expansion of Medicaid eligibility and a provision allowing adult children up to age 26 to remain on their parents' insurance.

The U.S. Justice Department has appealed the ruling. It argued in a court filing earlier this month that Congress had the power to enact a minimum health insurance requirement because it is a "rational means of regulating the way participants in the health care market pay for their services."

In his brief with the 11th Circuit Court of Appeals in Atlanta, Koster compared the federal law's penalties on people who don't have health insurance to a hypothetical law penalizing a northwest Missouri farmer because he decides not to plant wheat. More specifically, Koster said, the insurance mandate would be similar to Congress penalizing people for not undergoing an annual prostate exam, not vaccinating their children or not maintaining a specific body-mass as a means to control obesity.

Koster said justifying the insurance mandate under the congressional authority to regulate interstate commerce would be "a dramatic and unsupported expansion of its authority" that would amount to "the establishment of a federal police power."

Koster, however, suggested the appeals court could strike down the individual insurance mandate while still allowing the rest of the federal health care law to remain intact. He also said mandates for certain businesses to provide insurance to their employees would be allowed under the Constitution's power for Congress to regulate commerce.

Koster also outlined several alternatives under which the insurance mandate could be upheld -- though he described them as challenging interpretations. Those include allowing states to opt in or out of the federal health care law, upholding the penalty under Congress' power to levy taxes or allowing an exception to the historical understanding of the commerce clause restrictions that is narrowly tailored for health care.