Health Reform WK-EDGE Supreme Court agrees to hear Affordable Care Act individual mandate case
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Friday, March 6, 2020

Supreme Court agrees to hear Affordable Care Act individual mandate case

By Cathleen Calhoun, J.D.

The high court will decide another Obamacare case, but will this one make all the difference?

The U.S. Supreme court granted California and other states’ petition for certiorari in The States of California, et al. v The State of Texas after the Fifth Circuit’s decision upheld the finding that the individual mandate in the Patient Protection and Affordable Care Act (P.L. 111-148) (ACA) was unconstitutional. The Court’s grant of certiorari is limited to the question of whether reducing the amount specified in Section 5000A(c) of the ACA to zero rendered the minimum coverage provision unconstitutional, and the question of whether the minimum coverage provision is severable from the rest of the ACA.

ACA. The ACA contains a provision giving individuals a healthcare choice – either purchasing health insurance or paying to the IRS what is called in the law a "shared responsibility payment." The mandate was written into the law to expand the health insurance risk pool to include the young and healthy. Congress reduced the "shared responsibility payment" to zero, but did not repeal the ACA.

Fifth Circuit. In December 2019, the Fifth Circuit, in a 2-1 opinion, upheld the Texas federal district court’s ruling that the individual mandate in ACA was unconstitutional. The Court agreed with the lower court in concluding that the individual mandate was no longer a constitutional exercise of congressional power with the amount specified in the ACA changed to zero. The Court found the issue of severability much more difficult. The Court said that the lower court failed to carry out "the inherently difficult task of severability analysis in the specific context of this case." The intervenor states argued that every provision was severable from the individual mandate. Ultimately, the Court remanded the issue and ordered the lower court to "employ a finer-toothed comb on remand and conduct a more searching inquiry into which provisions of the ACA Congress intended to be inseverable from the individual mandate." (see ACA individual mandate unconstitutional; remanded for further study of severability).

U.S. House of Representatives. On January 3, 2020, the petition for certiorari was filed. On the same day, the U.S. House of Representatives filed a motion to expedite consideration of the petition for a writ of certiorari filed by petitioner with the U.S. Supreme Court. In its filing, the U.S. House of Representatives noted that the Fifth Circuit decision was divided and that the decision "…poses a severe and immediate threat to the orderly operation of the health-care marketplace."

What’s next. The U.S. Supreme Court did not announce when it will hear the case. Although a decision could come sooner, if the high court follows usual procedures, the case will be heard in the fall of 2020, with a decision in 2021.

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