Earlier I published a post analyzing the decision in the DC healthcare case, here.
One major point still needed to be addressed.
Judge Kessler’s reasoning that citizens are burdening the nation’s healthcare system without buying insurance ignores the fact that the burden is imposed by federal government mandate, and not by private contract law
In short, Judge Kessler argues that people without insurance put a burden on the healthcare system because hospitals (or rather ER departments, which are usually separate legal entities form the hospital) must treat patients whether they can pay or not under EMTALA. This does not matter for purposes of determining if not purchasing health insurance is economic activity. Rather than go into detail I refer the reader to the following posts by writer Avik Roy: