U.S. Supreme Court Now Likely to Rule on ACA in 2012 (expanded version)
A significant development earlier this month would seem to make it more likely that the U.S. Supreme Court will consider legal challenges to the Affordable Care Act (ACA) soon. In the case of Florida v. The U.S. Department of Health and Human Services, both the plaintiffs and defendant appealed parts of a lower court ruling on the case directly to the Supreme Court, asking that a decision be made during the Court's current term. If the Court decides to hear the case, as many legal scholars expect, a ruling about the law would be made by next summer.
The Florida case is one of many legal challenges to the federal health care reform law. Since 2010, opponents have filed some 30 cases in state and federal courts challenging the ACA or attempting to block its implementation. Although plaintiffs have made various arguments against the law, the focus of most of the federal lawsuits, as it is in the Florida case, has been the validity of a key provision in the Act, the individual mandate. Most litigants have questioned whether Congress was within its authority, under the Commerce Clause of the U.S. Constitution, to require individuals to purchase health care insurance. So far, with a few notable exceptions, the answer appears to be yes.
Many cases were withdrawn by the plaintiffs or dismissed by federal district courts for lack of standing or other jurisdictional concerns. Several federal district and appellate courts, however, have reached decisions on the merits about the individual mandate and other legal questions. Although many appeals are pending, so far there are only two active cases, including the Florida case, where the current controlling opinion is that the individual mandate is unconstitutional. In all of the remaining cases, the most current judicial opinion favors the defense, and no current decision will block implementation of any part of the law before 2014.
So far, the Florida v. U.S. DHHS case is the highest-profile challenge to the law. It was filed immediately after President Obama signed the ACA and now includes as parties officials from 26 states, including Colorado, the National Federation of Independent Business and two individual plaintiffs. In January, a Florida District Court judge ruled that the ACA's individual mandate provision was unconstitutional and as a consequence the entire law was invalid. On Aug. 12, 2011, a three-judge panel on the 11th Circuit Court of Appeals affirmed that the individual mandate portion of the ACA was unconstitutional. However, the panel also found that the individual mandate was severable from the remainder of the law, so only that portion was invalid. Because the Court refused to issue an injunction blocking implementation and the individual mandate is not effective until 2014, the decision effectively has no current impact.
Several other closely watched federal court rulings have been issued since May. In June, the 6th Circuit Court of Appeals, in a case filed by the Thomas More Law Center, found that Congress had a rational basis to impose an individual mandate and upheld the ACA's constitutionality. A judge in the Eastern District of Michigan previously had dismissed the case by rejecting the plaintiff's argument that Congress cannot compel a person to buy health insurance under the Commerce Clause of the U.S. Constitution.
On Sept. 8, 2011, the Federal Appeals Court in the 4th Circuit ruled in favor of the ACA in two cases. In one lawsuit filed by Liberty University, the federal court in the Western District of Virginia ruled that the decision to forgo insurance was not economic "inactivity" as claimed by the plaintiffs, but instead a decision to pay for insurance at a later date. The three-judge appeals panel, in a 2-1 decision, vacated that judgment and dismissed the case for lack of subject matter jurisdiction. The dissenting judge argued that that the court should hear the case and uphold the constitutionality of the ACA.
In the second case, filed by Virginia's Attorney General, the 4th Circuit vacated a decision made in the Eastern District of Virginia against the ACA. In that ruling, the judge found Congress lacked the power to compel an individual to purchase a commodity in the private market. In his ruling, the judge found the entire Act unconstitutional, but refused to issue an injunction barring its implementation. The Appeals Court unanimously vacated the lower court's decision, and remanded it with instructions to dismiss for lack of subject matter jurisdiction.
Also in September, a federal judge in Pennsylvania, similar to the Florida decision, found that the individual mandate provision violated the Commerce Clause as well the Takings Clause of the 5th Amendment. Unlike other courts, however, the Judge in Goudy-Bachman v. U.S. Department of Health and Human Services found that only two other ACA provisions were inseparable from the individual mandate: the guarantee issue provision and a section that prohibits insurers from excluding individuals with a pre-existing condition from coverage.
Two other cases are before federal courts of appeal. In both, one in the D.C. Circuit and the other in the 5th Circuit, lower courts upheld the individual mandate and dismissed the challenge. Arguments in the D.C. Circuit case are scheduled for this year, and it is anticipated the 5th Circuit case will be heard next year. Other Federal district court decisions are pending in D.C., Mississippi, Ohio, Oklahoma and Texas.
Given the number of lawsuits challenging the ACA, the differences in several key decisions, and the significant legal questions raised by the case, most legal experts predict that the U.S. Supreme Court ultimately will determine the law's constitutional validity. So far, the Court has resisted several attempts to fast track an opinion, preferring instead to allow the appeals process to play out. Now that several conflicting appellate decisions have been made and a direct appeal has been filed with the Court, it seems likely the Supreme Court will rule on the ACA by the middle of next year.