Much Ado About Nothing: Why the War over the Affordable Care Act’s Individual Mandate Will End with a Whimper and Not a Bang

Since the emergence of “modern” medicine in America at the turn of the twentieth century, political debate has raged over reforming and expanding access to the healthcare system.  While the movement enjoyed limited victories over the years, the Patient Protection and Affordable Care Act of 2010 (PPACA or the Act) represents the first successful attempt at comprehensive healthcare reform.  On March 23, 2010, the day President Obama signed the bill into law, the attorneys general of thirteen states filed suit in United States District Court challenging the constitutionality of various provisions of the Act.  While many prior failed attempts at healthcare reform have included some version of an “individual mandate,” the PPACA represents the first time Congress enacted a general requirement that all Americans obtain health insurance or pay a penalty.  It is this provision—which one author called “health care reform’s most controversial element”—that lies at the heart of the constitutional challenges. . .