If it’s an economic decision, the federal government can make it for you. That’s the takeaway from a ruling this afternoon by a federal judge in Michigan.

Judge George Caram Steeh, who was considering the constitutionality of the PPACA’s individual mandate, which requires all Americans to purchase private health insurance, said the requirement is constitutional. The judge’s reasoning boiled down to the argument that even though the decision not to purchase health insurance may not be economic activity, which the federal government is allowed to regulate under the Constitution’s Commerce Clause, it is an economic decision, because it has ramifications across the entire health care market. The decision noted that in United States v. Lopez, the Supreme Court ruled that, under the Commerce Clause, the federal government has the authority to regulate “those activities that substantially affect interstate commerce.” The choice not to purchase health insurance meets that criteria, according to the judge, and therefore the federal government has full authority to regulate it:

There is a rational basis to conclude that, in the aggregate, decisions to forego insurance coverage in preference to attempting to pay for health care out of pocket drive up the cost of insurance.