Challenges to health reform are a multi-faceted, fast-moving area of litigation.
At least twenty cases challenging the Patient Protection and Affordable Care Act (ACA) have now been filed in federal courts in fifteen states. Florida’s Attorney General, joined by officials from twelve other states, filed suit immediately after the ACA was signed on March 23, 2010. Virginia, which has passed a law that prohibits the federal government from requiring residents to obtain health insurance coverage, filed later the same day.
The flagship claim in most of these cases is that the Act oversteps Congress’ power under the Commerce Clause. Many plaintiffs also argue that the ACA violates Congress’ authority to levy taxes. Other claims have been raised as well: the Thomas More Law Center and several practicing Christians who do not wish to purchase health insurance filed in the Eastern District of Michigan alleging that the ACA also violates their First Amendment right to free exercise of religion. The federal government has responded that the ACA is a permissible application of Congress’ constitutional authority and that in any event plaintiffs lack standing to bring these claims.
The standing argument has met with mixed success. A judge in the Southern District of California dismissed a case on standing grounds in August. That decision has been appealed to the Ninth Circuit, with an almost simultaneous petition for certiorari to the Supreme Court, which was denied on November 8. On November 4, a Tennessee district judge dismissed a similar health reform challenge because of lack of standing.
Most courts, however, have found standing, but have reached differing decisions on the merits.
In early August, Virginia’s challenge became the first case to proceed beyond the pleadings stage when Judge Hudson denied the federal government’s motion to dismiss. The court has heard argument on motions for summary judgment (D) (P), with a ruling expected by the end of the year.
On October 7, Judge Steeh of the Eastern District of Michigan denied a motion for preliminary injunction in the Thomas More case, and dismissed. Although conceding that the Commerce Clause question “arguably presents an issue of first impression,” Judge Steeh found the ACA to be a constitutional exercise of Congress’ Commerce Clause power and declared the tax argument to be “without merit.”
Judge Vinson, senior judge of the Northern District of Florida, reached the opposite conclusion a month later. He found, first, that the assessment imposed by the ACA is not a tax but rather a non-tax penalty. Although he did not rule on the merits of the federal government’s claim that the ACA is a permissible use of Congress’ Commerce Clause authority, he permitted that claim to go forward and appeared sympathetic to the plaintiff’s argument. “At this [motion to dismiss] stage in the litigation,” he wrote, “this is not even a close call.” Judge Vinson also allowed the Plaintiffs to proceed with a claim that ACA commandeers the Medicaid program.
The latest filings, news and information concerning these and other anti-ACA cases can be found on the National Health Law Program’s Health Reform Litigation page.
This information was developed by Jane Perkins, legal director, and Corey Davis, staff attorney, for the Network for Public Health Law – Southeastern Region at National Health Law Program.
The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state.