If I were placing bets I would bet on the U.S. Supreme Court upholding the Affordable Care Act and its individual mandate. Two thoughts:
One. Keep in mind this current situation is deja vu as to the racial civil rights issues the U.S. Supreme Court dealt with in the 1960s. For example, in a 1964 U.S. Supreme case originating out of Atlanta, called the Heart of Atlanta Motel, Inc. v. United States, the issue was whether the Atlanta motel could be forced by law to allow blacks as guests in its motel. Here is the Supreme Court opinion. The motel argued the Commerce Clause did not apply in a manner that, in the motel’s view, resulted in “involuntary servitude” requiring the motel to rent rooms to customers not of its choosing.
The Supreme Court did not accept the Atlanta motel’s argument and held that “the Civil Rights Act of 1964 is a valid exercise of Congress’ power under the Commerce Clause as applied to a place of public accommodation serving interstate travelers.”
Here is an excerpt from the Heart of Atlanta Motel Supreme Court opinion referring to the motel’s argument. Note the motel’s attempt to use the notion of liberty in its argument:
[The motel argues it] is deprived of the right to choose its customers and operate its business as it wishes, resulting in a taking of its liberty and property without due process of law and a taking of its property without just compensation; and, finally, that, by requiring appellant to rent available rooms to Negroes against its will, Congress is subjecting it to involuntary servitude in contravention of the Thirteenth Amendment.
Two. I heard yesterday on the PBS Washington Week show an excellent analogy. That is, when a person goes to buy a car and decides not to make the purchase, the person ends up with no car and no one else otherwise bears the cost providing a car to this person. Thus, arguably in this example commerce is not affected from a constitutional law perspective.
However, by contrast, a person without health insurance who enters a hospital will most likely still obtain the medical services regardless of the absence of insurance. The fallout here — different from the car example above — is that other individuals who do have health insurance are adversely affected in that their health care costs and premiums will reflect increases taking into account these uninsured individuals.