Eleventh Circuit rules individual health care mandate unconstitutional

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[JURIST] The US Court of Appeals for the Eleventh Circuit [official website] ruled [opinion, PDF] 2-1 Friday that the individual mandate in the Patient Protection and Affordable Care Act (PPACA) [HR 3590; JURIST news archive] is unconstitutional. Although the decision [JURIST report] in the US District Court for the Northern District of Florida [official website] rejected the entirety of the law, the Eleventh Circuit judges upheld the law without the mandate. The opinion stated that Congress had exceeded its authority under the Commerce Clause [Cornell LII backgrounder], calling it a “wholly novel and potentially unbounded assertion of congressional authority.” They also agreed with the defendants that the Tenth Amendment [text] powers reserved to the states were usurped by Congress: “Congress cannot directly compel a state to act, nor can Congress hinge the state’s right to regulate in an area that the state has a constitutional right to regulate on the state’s participation in a federal program. Either act is clearly unconstitutionally coercive.” The dissent, by Judge Stanley Marcus, disagreed:

Setting aside the lack of any precedent on point, a Tenth Amendment challenge to the individual mandate fails for an additional, and critical, reason: when a federal law is properly within Congress’ delegated power to enact, the Tenth Amendment poses no limit on the exercise of that power. Since the individual mandate falls within Congress’ commerce power, its enactment is a proper exercise of a power “delegated to the United States by the Constitution.” The Tenth Amendment, therefore, has no individual role to play. In short, the plaintiffs’ individual liberty claims find little support in the Constitution—whether pegged to the Fifth Amendment’s Due Process Clause or the Tenth Amendment’s reservation of power to the people. At bottom, Congress rationally concluded that the uninsured’s consumption of health care services, in the aggregate, shifts enormous costs on to others and thus substantially affects interstate commerce.

A spokesperson for President Barack Obama said [press release] the administration “strongly disagree[s] with this decision and we are confident it will not stand.” Also on Friday, the Ohio Supreme Court [official website] ruled that Ohioans are entitled to a petition-driven ballot initiative that could potentially block the PPACA in the state [Toledo Blade report].

Oral arguments [JURIST report] in the Eleventh Circuit’s review of the PPACA were heard in June. Former solicitor general Paul Clement, representing Florida and 26 other states backing the lawsuit, argued that Congress has never before used the Commerce Clause power to force citizens to purchase something. The Department of Justice (DOJ) [official website] argued that the choice not to purchase insurance affects everyone. Also in June, the US Court of Appeals for the Sixth Circuit [official website] found the individual mandate provision constitutional [JURIST report]. The court determined that the penalty is not a tax for purposes of the Internal Revenue Code [text] and went on to state that the health care market “is large and is inextricably linked to interstate commerce” and that those who choose to not purchase health insurance substantially affect interstate commerce through cost-shifting that drives up insurance premiums. As a result, the Court determined that Congress did not violate the Commerce Clause, finding it had a rational basis for the individual mandate because “the provision regulates active participation in the health care market, and in any case, the Constitution imposes no categorical bar on regulating inactivity.” The US Court of Appeals for the Fourth Circuit [official website] heard arguments [JURIST report] over PPACA in May but has not yet issued a ruling.

Read more detail on JURIST – Paper Chase

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