How is the Affordable Care Act Different from Medicare?

Elizabeth Price Foley,

Release Date
June 28, 2012



If Social Security and Medicare are constitutional, why isn’t the individual mandate from the Affordable Care Act also constitutional? Law professor Elizabeth Price Foley explains that the Social Security and Medicare laws are based on a different congressional power than the Affordable Care Act. Social Security and Medicare fall under Congress’s power to tax and spend on behalf of U.S. citizens, while the individual mandate is based on the power to regulate commerce.
The question before the Supreme Court is whether the power to regulate commerce includes the power to compel people to participate in commerce. Is it within Congress’s constitutional authority to require individuals to buy health care if they do not want to do so?
Professor Elizabeth Price Foley says Congress could have solved the problem of access to health care for the uninsured without using its commerce power. It could have simply invoked the same principle it used with Social Security and Medicare. If that had happened, the Affordable Care Act would not be in a case pending before the Supreme Court.