The new health care law, Pub. L. No. 111-148 (Mar. 21, 2010) has controversial criminal justice ramifications apart from those provisions of the massive bill making health care policy changes. It vitiates foundational principles of criminal law with respect to trial and sentencing by: (1) diminishing the mens rea requirement under 18 U.S.C. §1347; and (2) requiring the Sentencing Commission to enact substantive Guidelines with Congressionally-mandated specific offense characteristics. For pre-publication copy of new article I wrote, leave comment.