For those who reckon that the federales are powerless to regulate health insurance, let me remind them of Gonzales v Raich, wherein the conservative SCOTUS held that the federales had the power under the interstate commerce clause to criminalize home grown cannabis for medicinal use. From the concurrence of Fat Tony Scalia:
"And the category of 'activities that substantially affect interstate commerce'... is incomplete because the authority to enact laws necessary and proper for the regulation of interstate commerce is not limited to laws governing intrastate activities that substantially affect interstate commerce. Where necessary to make a regulation of interstate commerce effective, Congress may regulate even those intrastate activities that do not themselves substantially affect interstate commerce." (emphasis added).