Kennedy’s “Heavy Burden of Justification” Approach, and Whether the Nature of the Health Care Insurance Market Can Satisfy It

Reading the tea leaves of Justice Kennedy’s questions in the transcript of this morning’s argument, Kennedy seems to be of the view that requiring a mandate under the Commerce Clause requires a “heavy burden of justification,” and that his major question is whether the uniqueness of the health care market satisfies that heavy burden. Here are Kennedy’s comments, with the first block of questions to SG Verilli arguing in defense of the mandate, and the second to Michael Carvin challenging the mandate:

1) Could you help — help me with this. Assume for the moment — you may disagree. Assume for the moment that this is unprecedented, this is a step beyond what our cases have allowed, the affirmative duty to act to go into commerce. If that is so, do you not have a heavy burden of justification?

I understand that we must presume laws are constitutional, but, even so, when you are changing the relation of the individual to the government in this, what we can stipulate is, I think, a unique way, do you not have a heavy burden of justification to show authorization under the Constitution?

2) But the reason, the reason this is concerning, is because it requires the individual to do an affirmative act. In the law of torts our tradition, our law, has been that you don’t have the duty to rescue someone if that person is in danger. The blind man is walking in front of a car and you do not have a duty to stop him absent some relation between you. And there is some severe moral criticisms of that rule, but that’s generally the rule. And here the government is saying that the Federal Government has a duty to tell the individual citizen that it must act, and that is different from what we have in previous cases and that changes the relationship of the Federal Government to the individual in the very fundamental way.

And then later, to Michael Carvin, arguing on behalf of the challengers:

[T]he government tells us that[] . . . the insurance market is unique. And in the next case, it’ll say the next market is unique. But I think it is true that if most questions in life are matters of degree, in the insurance and health care world, both markets — stipulate two markets — the young person who is uninsured is uniquely proximately very close to affecting the rates of insurance and the costs of providing medical care in a way that is not true in other industries. That’s my concern in the case.

Reading the tea leaves, it sounds like Justice Kennedy accepts the basic framework of the challengers that mandates are different and especially troubling. Instead of saying that mandates are therefore banned, however, Justice Kennedy would require the government to show some special circumstances justifying the mandate in each case. The unanswered question in this case is whether the special economics of the health care market justifies the mandate here.