Congress has the power to legislate with regard to activity that, in the aggregate, has a substantial effect on interstate commerce.

While Congress did not, to my knowledge, calculate aggregate dollar values for the nationwide effects of racial discrimination in 1964, in 1994 it did rely on evidence of the harms caused by domestic violence and sexual assault, citing annual costs of $3 billion in 1990 and $5 to $10 billion in 1993.

When Congress exercises the powers delegated to it by the Constitution, it may impose affirmative obligations on executive and judicial officers of state and local governments as well as ordinary citizens.

Under the Articles of Confederation, the national government had the power to issue commands to the several sovereign states, but it had no authority to govern individuals directly.

You can't have these sort of prices without a substantial effect on demand.

The strongest effect is for colorectal cancer. There's also a substantial effect for breast and ovarian cancer.