The Affordable Care Act (ACA) has helped millions of Americans gain access to affordable health coverage. But its implementation has come under attack: an initial decision by a district court judge found that individual mandate was beyond Congress’ power and ordered its suspension; later on another judge issued similar judgment and struck it down altogether.
The 5th Circuit instructed the district court to rehear the case, with special attention paid to whether other provisions of ACA could be considered as inseverable from its mandate. Now, however, only the Supreme Court will make this final judgment.
The Commerce Clause
The Commerce Clause gives Congress the power to regulate commerce between nations and among states, such as overseeing sales or purchases between states. Thus, congress can oversee sales or purchases between them.
Plaintiffs in this case contend that Congress violated its Commerce Clause authority by mandating health insurance coverage for individuals. Their argument is that being required to purchase health coverage forces them to spend money they otherwise wouldn’t spend, which they consider as harm and thus qualify them to sue under Article III, which allows federal courts to hear genuine cases or disputes.
The Fifth Circuit partially upheld a district court’s finding that the individual mandate is unconstitutional in its 2-1 ruling; however, they remanded for further analysis of severability by the Supreme Court; this means they will ultimately decide if the individual mandate is constitutional and what its impact would be on other parts of ACA provisions; to get there they first need to address threshold standing issues.
The Necessary and Proper Clause
In 2012, the Supreme Court upheld the individual mandate, holding that Congress has the authority to require Americans to purchase health insurance coverage. But in 2017, Congress altered this law by eliminating penalties for failing to obtain coverage – leading plaintiff states and two individuals to argue that due to no longer being treated as taxes by Congress, its power over commerce cannot justify such mandate.
The Supreme Court, however, found otherwise and held that plaintiffs lacked standing to challenge the ACA. According to long-established legal principles, federal courts can only decide cases or controversies with real parties involved and injuries likely to be remedied through favorable court decisions; as unenforceable mandates were not readily traceable by plaintiffs it could not be proven as being an “imminent or real threat to their rights. As a result the case was sent back down for further consideration in lower courts. The Supreme Court ultimately remanded back down for further consideration by lower courts before returning it back up top for further consideration by it to them for consideration by them for further consideration by all involved courts for further consideration by all concerned.
The Taxing and Spending Clause
The Constitution grants Congress the ability to levy taxes, imposts and excises; this clause, known as the Taxing and Spending Clause, ensures that Congress has enough funding for its operations.
In National Federation of Independent Business v. Sebelius, the Supreme Court upheld the individual mandate – mandating that most Americans purchase health insurance – as constitutional. Justices reasoned that since it constituted a tax under the Commerce Clause of the Constitution, Congress had this power over such matters.
Though the Fifth Circuit court upheld this finding, in December 2021 they determined that the penalty-less mandate was unconstitutional and should be struck down with all of ACA. Unfortunately this decision was put off due to lack of standing and severability argument.
Under Article III, to bring an action successfully under Article III a plaintiff must show both an injury which is both real and likely to be remedied by a favorable court ruling. According to the Fifth Circuit Court of Appeals, state plaintiffs did not meet this standard given their claims of injury were based on costs from various provisions within ACA that operate separately from mandates such as reporting requirements.
The Establishment Clause
The Establishment Clause prohibits federal legislation from creating laws regarding religion as established at a state level, in order to prevent a national church. Furthermore, this clause was intended by its framers of the Constitution as an attempt to create an invisible wall separating church from state.
Texas and other challengers contend that, with Congress having nullified the mandate’s penalty, it no longer constitutes a constitutional tax under the Establishment Clause. Furthermore, they contend that all aspects of ACA – guaranteed issue policies, community rating schemes and preexisting condition exclusions would become illegal without it because these components depend upon functioning individual mandates to function correctly.
Justice Barrett strongly criticized her opponents’ arguments during her confirmation hearings and appeared to indicate she will side with the majority of justices on the Court when the final verdict comes out. Time will tell whether this holds true when they make their final determinations.
