It's a tax, not purchase of a product or service, why so many of us have been tearing our hair out at the taxation of Social Security benefit dollars, tax on already taxed money is as un-Constitutional as you can get.
“How did Congress manage to mandate participation in Social Security and Medicare?
It’s a tax, not purchase of a product or service”
Exactly. Congress has the power to levy taxes and may compel their payment, including fines, penalties or even jail for those refusing to pay. So no one is free to opt out of the payment part of these programs. But no one is required to participate once they become eligible either. Having already paid for your Social Security and Medicare benefits during your working years, the government graciously gives you the option to forego any and all benefits from either program.
The Supreme Court has already ruled that SS is constitutional and for that reason, I don’t think the constitutionality of Medicare was ever challenged (since it’s the identical PAYGO structure of financing that relies heavily on a payroll tax paid by today’s workers to finance benefits for today’s retirees).
But in that regard, an individual mandate is virgin territory. While one in a theoretical sense can imagine one’s own personal payroll taxes being “banked” for future SS/Medicare benefits to be drawed upon during retirement, in reality your taxes pay for someone else’s benefits. With the individual mandate, you are being forced to pay for your own health insurance even if you believe insurance is a wasteful/inefficient way to purchase medical care. So I don’t think the constitutionality of an individual mandate can be grounded in the same SC logic that led to their upholding the constitutionality of SS.