“Part I addresses the Commerce Clause and includes what I think is the most thorough discussion so far of why the mandate is not authorized by the Supreme Court’s broadest-ever Commerce Clause decision, Gonzales v. Raich (pp. 6–10). Part I also addresses many other relevant Commerce Clause decisions, including lower court cases. Part II covers the Tax Clause, emphasizing that the mandate is a regulatory penalty, not a tax as defined by Supreme Court precedent (pp. 16–21). Finally, Part III discusses the Necessary and Proper Clause. Among other things, it explains why the mandate runs afoul of the five part test established in the Supreme Court’s most recent Necessary and Proper Clause decision, United States v. Comstock, which I also discussed in detail in this article.”

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“When a federal program is hemorrhaging taxpayer dollars and delivering poor results, policymakers should reform it. Fundamental Medicaid reform is desperately needed. Market-based principles should be introduced to re-align incentives of doctors and patients so that quality can increase and cost can decrease. Instead of addressing the many problems of Medicaid, Obamacare doubles down on the broken program and greatly adds to its rolls.”

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Texas doctors will be unable to accept new Medicaid patients under scheduled reimbursement cuts. ObamaCare further squeezes these physicians with more across the board cuts, which will lead to access problems.

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“Our economy will have to find a way to restore its growth in spite of ObamaCare, not because of it.”

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“The individual mandate, however, asserts authority over citizens that have done nothing; they’re merely declining to purchase health insurance. This regulation of inactivity cannot find a constitutional warrant in either the Commerce Clause, the Necessary and Proper Clause, or Congress’s taxing power. Such legislation is not ‘necessary’ to regulating interstate commerce in that it violates the Supreme Court’s distinction between economic activity (which often falls under congressional power as currently interpreted) and non-economic activity (which, to date, never has), it is not ‘proper’ in that it commandeers citizens into an undesired economic transaction.”

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“So here’s the bottom line: The new health reform law does have three notable cost-control mechanisms — two of which are very aggressive. None of the three, however, are likely to achieve their objective.”

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“Back when Secretary Sebelius was nominated for her current position, a colleague enthused that, ‘An insurance commissioner is a great choice for Secretary of HHS, because his or her direct contact with consumers provides unique insight into the challenges…..’ Unfortunately, Secretary Sebelius’ current direct contact with the Beltway political class and its ideological agenda obviously have far more significance than her previous direct contact with consumers, whose suffering under ObamaCare has only just begun.”

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The Administration promises to use political pressure to force insurers to take the blame for limited benefits and cost overruns. “This is one way ObamaCare imposes price controls. The legislation requires lots of new health insurance benefits—benefits that come with a cost. But Democrats sold it by telling people they would get more and pay less. It was a lie, and now Sebelius has to fain shock at the price increases.”

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“For the first time in American history, the federal government has attempted to ‘commandeer the people” by imposing on them an “economic mandate.” Such economic mandates cannot be justified by existing Supreme Court doctrines defining and limiting the powers of Congress. Upholding the power to impose economic mandates “would fundamentally alter the relationship of the federal government to the states and the people; nobody would ever again be able to claim plausibly that the Constitution limits federal power.”

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“The U.S. healthcare reform law will worsen a shortage of physicians as millions of newly insured patients seek care, the Association of American Medical Colleges said on Thursday. The group’s Center for Workforce Studies released new estimates that showed shortages would be 50 percent worse in 2015 than forecast.”

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