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Since "the regulation of commerce belong[s] exclusively to the National Legislature," only Congress and the federal government could handle the problem of maritime labor that had once fallen to the individual colonies.

So this case does not stretch...

The act taxed sailors to pay for their health care, rather than "requiring that sailors purchase it."

That 1798 Law has morphed into a good portion of current federal government. http://www.coausphs.org/phhistory.cfm

They closed the hospitals in 1981. So I guess it is all Rascally Republicans fault.


Source quoted above
Also nearby was the merchant mariner—a crucial laborer in an early American economy that was deeply dependent on foreign commerce. Sailors helped carry American produce to European, Caribbean, and Asian markets. They also brought foreign goods back home to the United States. But seafaring was extremely dangerous work. Storms and plagues frequently struck Atlantic waterways. Falling crates and crashing barrels caused great harm to life and limb. Indeed as Hawthorne observed, these working conditions often left returning sailors "pale and feeble."
End Quote

This whole case rests on the commerce clause. Congress can not regulate commerce in the states.
Hence Congress does not regulate Insurance...
That is a state issue always has been

Of Course if you get the right judge.....


Another article to consider
The Supreme Court created the right to privacy in the 1960s and used it to strike down a series of state and federal regulations of personal (mostly sexual) conduct. This line of cases began with Griswold v. Connecticut in 1965 (involving marital birth control), and includes the 1973 Roe v. Wade decision legalizing abortion.

The court's underlying rationale was not abortion-specific. Rather, the justices posited a constitutionally mandated zone of personal privacy that must remain free of government regulation, except in the most exceptional circumstances. As the court explained in Planned Parenthood v. Casey (1992), "these matters, involving the most intimate and personal choices a person may make in a lifetime, choices central to personal dignity and autonomy, are central to the liberty protected by the Fourteenth Amendment. At the heart of liberty is the right to define one's own concept of existence, of meaning, of the universe, and the mystery of human life."

It is, of course, difficult to imagine choices more "central to personal dignity and autonomy" than measures to be taken for the prevention and treatment of disease -- measures that may be essential to preserve or extend life itself. Indeed, when the overwhelming moral issues that surround the abortion question are stripped away, what is left is a medical procedure determined to be "necessary" by an expectant mother and her physician.

If the government cannot proscribe -- or even "unduly burden," to use another of the Supreme Court's analytical frameworks -- access to abortion, how can it proscribe access to other medical procedures, including transplants, corrective or restorative surgeries, chemotherapy treatments, or a myriad of other health services that individuals may need or desire?

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