Health Care Reform Law Heads Toward Supreme Court

No other piece of legislation signed into law by President Barack Obama has sparked more controversy than the Patient Protection and Affordable Care Act of 2010 (known as  “ObamaCare” to its critics) (P.L. 111-148).  After months of debate and controversy, the President signed the comprehensive health reform measure into law on March 23, 2010.  Dozens of lawsuits were promptly filed across the country contesting the bill’s constitutionality. In each of the suits, the main issue has focused on whether the “individual insurance mandate” provision that requires every American adult either to obtain health insurance or to pay a penalty for failing to do so is a violation of the Constitution’s Commerce Clause.  The lower federal courts have split on the matter, setting up a battle in the nation’s highest court.

Individual Mandate

Generally, opponents of the law contend that the individual mandate provision is unconstitutional as exceeding the scope of Congress’s powers. Supporters maintain that it falls within Congress’s authority to regulate commerce among the states and as an exercise of congressional power to tax and spend for the general welfare.  Every judge who has ruled on the issue has recognized that Congress has never previously imposed a comparably sweeping mandate under the Commerce Clause, and that the Supreme Court has never ruled on the issue of whether Congress has a general power to regulate “inactivity.”

Most recently, the Eleventh Circuit Court on August 12 struck down the individual mandate provision.  Writing for the majority of the court in Florida v HHS, Chief Judge Joel F. Dubina said Congress could do many things under the commerce clause, but one thing it could not do was “mandate that individuals enter into contracts with private insurance companies for the purchase of an expensive product from the time they are born until the time they die….The federal government’s assertion of power, under the Commerce Clause, to issue an economic mandate for Americans to purchase insurance from a private company for the entire duration of their lives is unprecedented, lacks cognizable limits, and imperils our federalist structure.”

 The Court, however, did not strike down the entire law, as a federal judge in Florida had done earlier, because the Circuit Court found that the insurance mandate could be scrapped without nullifying all of the sweeping law.  This was the second federal appeals court ruling on the constitutionality of the insurance mandate, and it conflicted directly with the first — by the Sixth Circuit (Thomas More Law Center, et al v Obama). The Sixth Circuit upheld the law, holding that the individual mandate “falls within Congress’s power to regulate activities that substantially affect interstate commerce.”

Keeping Score

 Twenty six federal lawsuits have been filed seeking to overturn the Act. To date, two district courts have found that the individual mandate exceeds Congress’s power under the Commerce Clause, and three district courts have upheld the mandate.  Two circuit courts have split.  More courts are expected to weigh in in the next few months.

Looking Ahead

The battle over the constitutionality of the Obama administration’s health reform law is almost certainly headed for the Supreme Court.  How the Court will rule is anyone’s guess, but a deeply divided Court would not be surprising, given the ideological gap that exists on the extent of the government’s reach raised by these lawsuits.  If the federal government prevails, Congress is likely to have an unlimited power to impose mandates of any kind.  If the plaintiffs win, the Court will have reaffirmed the importance of constitutional limits on federal power.

 The Supreme Court is likely to decide by January whether it will weigh in on the controversial case in the Spring, meaning that a ruling could come before the November 2012 election.  The stakes couldn’t be higher for the Justices, for lawmakers, for President Obama, and for the voters.