The requirement that most Americans purchase health insurance by 2014 was one of many controversial parts of the Obama healthcare law.

It has now been challenged and dismissed a couple times over, with close to two dozen challenges still awaiting review in federal court. The latest dismissal was a 54-page opinion by federal judge Norman Moon that examined the constitutionality of a healthcare requirement.

Specifically, the issue before the Virginia court was whether the federal government could, in fact, govern how and when Americans get healthcare insurance. The answer? The all-encompassing interstate commerce clause.

Judge Moon concluded that healthcare, in the aggregate, substantially affects interstate healthcare commerce – a conclusion that places the regulation of healthcare within the realm of the federal government. A Michigan judge who considered this exact issue came to the same commerce-based conclusion.

The Commerce Clause of the Constitution empowers congress to regulate interstate commerce, a broad activity that provides the basis for a range of federal regulation. Generally speaking, any business or commercial exchange falls under the commerce definition. In the healthcare context, there is an exchange of money for medical services. Opponents to the Obama healthcare law (lovingly referred to as Obamacare) fear that the large amount of government subsidized medical plans for uninsured and underinsured individuals will essentially equate to socialized medicine.

This is certainly not last challenge to the law. Some experts believe that the issue could go all the way up to the Supreme Court and will be trimmed away by the newly elected Republican Congress.

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