I've been sitting on the following comment, but in light of Wurble's last posting I feel compelled to release it.
I've read the judge's decision in VA. Someone put it up here:
http://www.scribd.com/doc/45218191/US-D ... urt-Ruling
The reason proposed as to the unconstitutionality of the health care plan is that the US govt is going beyond the bounds of the Commerce Clause. The analysis is as follows. In previous decisions of the Commerce Clause, the actions which were found to be within the scope of the Clause were those which people could engage in voluntarily. The examples given are cases where people were growing pot. Since they decided to grow pot, they voluntarily engaged in "economic activity", commerce. Once they voluntarily engage in the activity, then they become subject to federal regulation. In the case of the health care plan, people are subject to regulation ("you must buy insurance") even if people are not engaging in any commerce. The decision not to buy health care is not an "economic activity." (Just in the same way that the decision not to grow pot is not an "economic activity.")
The defense (i.e. the US govt) gives examples where the government can punish people for not acting but the judge notes that these examples are powers provided by other clauses of the constitution, not the Commerce Clause. E.g. people who do not pay taxes are fined but that's constitutionally okay because there is a constitutional clause which gives the government such power. (That is, taxation does not depend on the Commerce Clause.)
The decision also contains a discussion of whether or not the penalty for not getting insurance is a tax. If it were, then it would fall under the US govt power of taxation and the whole Commerce Clause reasoning would be moot. The judge examined "congressional intent" and found that when the bill was being debated, the penalty was specifically framed as something else than a tax. So the intent of congress was not taxation. (Yeah, they shot themselves in the foot real well trying to avoid the dreaded "tax" word.)
As much as I want to see universal health care, the judge's reasoning seems to me reasonable. IANAL and I'm certainly not a constitutional scholar so maybe there's some crucial thing I'm missing.
That's the only reasoning I've had a chance to look at. I don't think the Commerce Clause argument would have any impact on what the SD state legislature does though. So I'm not sure how they think their gun ownership requirement is going to help them make their point.
If the judge's reasoning is legally sound then I think any proposal which relies on the Commerce Clause to force people to get insurance is bound to fail. There may be no way out of the constitutional challenge short of making the health care system a single-payer system. Then it will be financed through taxes.