>The three-judge panel delivered a long opinion Wednesday with disagreement on some issues. But it affirmed a Michigan federal judge's earlier ruling that Congress can require Americans to have minimum insurance coverage.
>http://content.usatoday.com/communities/ondeadline/post/2011/06/federal-appeals-court-upholds-obama-health-care-law/1
>
>Opinion:
>http://www.ca6.uscourts.gov/opinions.pdf/11a0168p-06.pdf

I just finished reading the opinion with a couple thoughts.

The majority writes that :

Virtually everyone will need health care services at some point, including, in the aggregate, those without health insurance. Even dramatic attempts to protect one’s health and minimize the need for health care will not always be successful, and the health care market is characterized by unpredictable and unavoidable needs for care.
...
The obligation to provide treatment regardless of ability to pay is imposed by the Emergency Medical Treatment and Active Labor Act, 42 U.S.C. § 1395dd, state laws, and many institutions’ charitable missions. The unavoidable need for health care coupled with the
obligation to provide treatment make it virtually certain that all individuals will require and receive health care at some point. Thus, although there is no firm, constitutional bar that prohibits Congress from placing regulations on what could be described as inactivity, even if there were it would not impact this case due to the unique aspects of health care that make all individuals active in this market.


Judge Graham in his dissent offers:
The government recites the common refrain that the health insurance market is unique and attributes this to some blend of free-riding, adverse selection, universal participation, and unpredictability as to when and how much care might be needed. This should comfort the court, the government says, because Congress will not need to resort to such measures as the mandate again, or at least not very often. This assurance is troubling on many levels and should hardly be heard to come from a body with limited powers. The uniqueness that justifies one exercise of power becomes precedent for the next contemplated exercise. And permitting the mandate
would clear the path for Congress to cause or contribute to certain “unique” factors, such as free-riding and adverse selection,3 and then impose a solution that is ill-fitted to the others.4
...
3) The free-riding problem is substantially one of Congress’s own creation, see Emergency Medical Treatment and Active Labor Act, 42 U.S.C. § 1395dd (requiring hospitals with emergency departments to provide the care necessary to stabilize patients with emergency medical conditions, without regard to a patient’s ability to pay for the care received), and the adverse selection problem will be exacerbated by the guaranteed issue provision, in that supply will be guaranteed to high-risk individuals. Though these policies might be reasonable, Congress’s compassion does not allow it to exceed the limits of its constitutional powers.


Essentially the Judge is pointing out that because Congress has previously mandated emergency care and that mandate now contributes to cost shifting does not allow Congress to point to said cost-shifting to justify an individual must carry insurance. Otherwise future Congress' would be encouraged to "cause or contribute" to "unique" factors of other industries and then enact mandated purchases citing a "unique" need partially or wholly based upon Congress' own actions.

This case does not address the 10th Amendment issues as it was brought by individuals yet it is now the first potential Supreme Court challenge to the individual mandate.