The Supreme Court and the Affordable Care Act

As I mentioned a couple of days ago, the United States Supreme Court will be hearing arguments regarding the constitutionality of the health care reform law, beginning today, March 26th. With an allotted time of six hours for oral arguments, over the next three days, the justices will consider four legal issues, based on three different cases and the opposing positions of the legal representatives of those cases.

Issue 1. The Individual Mandate

This has been the central argument regarding the PPACA – whether the government can require that individuals purchase health insurance , or face paying a fine.  Those who oppose this part of the bill do so under the Commerce Clause of the Constitution which provides the government with the authority to regulate interstate economic activity.  Supporters of the individual mandate maintain that a failure to purchase health insurance has a direct economic effect, and results in taxpayers being stuck with the bills for those not otherwise covered.  Opponents state that not doing something has the effect of economic inactivity and therefor cannot be regulated by the federal government.

Issue 2. Tax Anti-Injunction Act

Simply put, the Anti-Injunction Act prohibits courts from hearing lawsuits challenging a federal tax.  It will mean that the Court will either rule that the Anti-Injunction Act applies or doesn’t apply in this matter, and therefor, whether this aspect of the challenge may or may not go forward.

Issue 3. The Question of Severability

With regard to this portion of the debate,  the Court will hear arguments as to whether the entire health care reform should be invalidated if the individual mandate is found to be unconstitutional.  In other words, can it be severed from the PPACA, or must the entire law be found as exceeding the limited and enumerated powers of Congress as granted them by the Constitution.

Issue 4. Federalism and Medicaid

This final set of arguments will be presented to the Court on Wednesday and deals with the possibility that Congress may have also exceeded its powers by placing burdensome conditions on the States through coercion.  The claim has been that the federal government has threatened to withhold all federal funding under the Medicaid program.  The PPACA provides for expansion for Medicaid coverage, something that would place an even greater weight on already overburdened States.

Possible Outcomes

There are a few ways that the Court could rule on these issues.  One is that the Court simply decides that the PPACA, in its entirety, is constitutional and that the law move forward as written and scheduled.  A second outcome could be that the individual mandate is barred by the Constitution, while allowing the rest of the law to stand.  A third possibility is that the Court finds that if the individual mandate fails to prevail, the entire PPACA will fall along with it, because the mandatory purchase of insurance is the very foundation upon which the PPACA is built.  Lastly, the Court may decide that the entire matter has not ripened, and will dismiss the cases.  In other words, as the law does not come into full effect until 2014, no one has been forced to purchase insurance or been fined for not doing so, and therefor there is no action for the Court to determine.   Four federal appellate courts have issued rulings with mixed results, with two upholding the law, one coming to the opposite conclusion, finding it unconstitutional, and a fourth dismissing two cases for lack of standing – the lack of ripeness argument.

It’s a complicated set of issues and the Court has its hands full.  Although six hours may not seem like a lot of time for oral arguments, it is one of the lengthiest that the Court has allowed in decades.  There are volumes of legal briefs, from both sides of each issue, and lower court rulings to pour over.   Experts believe that the justices will make a decision sometime in June.  It’s going to be an interesting debate, and the Court’s ruling may very well be an election cycle game-changer.


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15 Responses to The Supreme Court and the Affordable Care Act

  1. Lisa Renee says:

    Good morning Empress, wow, just wow! You broke that down so lay people like me can reallly wrap their brain around it. Thank you, your reply to my last comment made it clear you are certainly better versed in legalese than I am. Your resume is quite impressive 🙂 Quick question on a sunny monday. Is this akin to what happen in New York when Roosevelt Island was built & the tram had to be free of charge to avoid the gov’t of being accused of forcing people to spend money on transportation should they choose to live there?? Have a great day, Lisa Renee

    • Lisa, Sorry for the delayed response on my part. I can’t really offer an honest opinion about the Roosevelt Island/tram question, because, quite simply, I’m just not that familiar with it. There may be others who could offer more information than I could. In the meantime, I’ll find what I can and see if it makes any sense to me, and if the comparison is a reasonable one.

  2. Adgirl says:

    Everyone should have great medical care. The question is how it is implemented. The resentment over the HC act seems to be a result of popular anger of “how” it was passed and the mystery about “what” was passed. If the court strikes down key parts of the act, the billions of dollars already spent by state governments and private industry to set up the networks will have been wasted.

    What a mess.

  3. Donna says:

    The Onion had an amusing article, I didn’t share, too man f bombs

  4. melthehound says:

    I just have one question about Congress and the Constitution. I know this is a much broader subject than the one offered here but here is the question.

    Since When does Congress Care about the Constitution?

    • Viewer 5 says:

      Hi, Jeffie!

    • Hey Jeff, Thanks for the morning laugh. All BS aside, Congress makes a habit out of turning the Constitution on its head. I think its members know as much about what it contains as they do about this health care law they passed.

  5. melthehound says:

    …. or any other government entity for that matter..,,.

  6. Viewer 5 says:

    I’m sorry. I don’t understand any of this. I don’t know what the premiums would be. But as we “all” pay into Medicare (which became, to my understanding, broken under Part D, helping big pharma sell more drugs) I don’t see what the big deal is in paying into a system when one is healthy, if it guarantees one’s care in the longrun, or in the case of disaster.

    I don’t understand why everyone in Massachusetts is supposedly “happy” with romneycare but it’s just no good whatsoever for the rest of amurica. I think people are selfish, uninformed, and petty. If they don’t see a direct positive correlation to their pocketbook, it’s no good. I’m sorry, I know we’re supposed to debate the legality of this, but I can’t help seeing the overall picture, and that is that our country is full of people who have no understanding of disaster or assistance until it directly involves their own thin skin, then out goes the hand to FEMA or whomever with the caveat that they’ve “paid” into the system (that two weeks prior they claimed they shouldn’t have to pay into.)

    It reminds me of the “innocent” debate of HIV in the 80’s. No one gave a shit until some young “innocent” people contracted HIV from a blood transfusion. “Innocent?” Really?!!!

    The only moral issue about people not being able to afford healthcare, in my opinion, is the selfish motherfuckers who perceive everyone who can’t afford it as “other.” THERE IS NO “OTHER” IN HUMANITY. Only the petty narrow-mindedness of people who were FORTUNATE enough NOT to have some sort of DISASTER happen to them. And they think it’s because they’re good people or they’ve “worked hard.” It’s a false premise based on illusory selection of information that supports their pet thesis that americuh was founded on individual responsibility. Meanwhile, they’ve got pensions and healthcare from their former employer (which is NO LONGER OFFERED IN THIS DECADE, TO MY GENERATION, BY THE SAME EMPLOYER) and UGH! I can’t… I’m sorry Empress, this whole thing makes my blood boil.

    • V5, I’ve read tons of materials trying to make sense of the PPACA, and its about as clear as the tax code. There are provisions that have already begun and some that won’t take effect until 2020. The portions dealing with Medicaid expansion, out-of-pocket premiums, cost sharing, States’ burdens, and health insurance exchanges require a trail guide and a compass to maneuver through. Then there are exemptions (waivers) for companies, a number of which have already been granted, and continue to be. There are new tax structures and credits based on FTEs, and so on and so on.
      It should make your blood boil. We are supposed to be the most powerful country in the world and nobody seems to be able to get their shit together long enough to do something, in an honest and effective way, that really reforms how we get health care.
      That the word “affordable” is even a part of the name of this bill is just laughable.

      • Viewer 5 says:

        Empress – they were saying how complicated it is on the teevee yesterday morning. Thank you for trying to make heads or tails of it. It’s sooooo weird. I did hear one thing – a commenter last night said that he didn’t think Justice Kennedy would want to go down in history as the person who defeated the bill for the *beginning* of healthcare that many presidents have tried to work on. So, there’s that. 😦

  7. Adgirl says:

    A commenter on the called the HC Act a platypus.

    You know, that oddball duckbilled aquatic mammal with a beaver tail that lays eggs.

  8. Adgirl says:

    It was speculated somehere that Obama might have heard a leak of the SC vote. LOL. My hubs and I speculated this weekend about how many CIA bugs were planted in the Supreme Court deliberation rooms.

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