Beginning Monday, March 26, the Supreme Court will begin hearing oral arguments on the Patient Protection and Affordable Care Act. The Supreme Court will hear 6 hours of oral arguments spread out over three days, which is unprecedented in the last half century.
Signed into law by President Obama nearly two years ago to the day, the Affordable Care Act is a Health Care Law seeking to improve the nation’s health care system by increasing access to health coverage and introducing new protections for people who have health insurance.
Some of the Health Care Law provisions have already been implemented (for example, the prohibition against excluding coverage based on preexisting conditions and children staying on their parent’s healthcare plan until their 26th birthday), while provisions such as the controversial individual mandate are yet to be implemented.
A majority of the states, numerous organizations, and individual persons, have filed actions in federal court challenging the constitutionality of the Affordable Care Act. After split decisions rendered by the four US Circuit Courts, the matter is now before Supreme Court for review.
The Supreme Court has scheduled six hours for oral arguments from March 26–28, 2012. The four issues before Supreme Court include the following:
1. Minimum Coverage Provision (also known as the individual mandate)
This provision requires that virtually all legal residents of the United States obtain minimum essential health insurance coverage for each month starting in 2014, or pay a penalty that will be included with the individual’s federal tax return. The issue before the Supreme Court is whether Congress has authority to require individuals to purchase health insurance under the Commerce Clause of the US Constitution. The standard under the Commerce Clause is whether the law regulates economic conduct with a substantial effect on interstate commerce.
2. Severability
If the individual mandate is an impermissible exercise of Congress’ power, then the Supreme Court must decide whether the individual mandate can be “severed” from the rest of the Health Care Law, leaving the rest of the Act’s provisions intact.
3. The Medicaid Expansion
Whether Congress exceeded its powers and violated principles of federalism by expanding the Medicaid program and withholding of funding from states that do not participate in the program?
4. Anti-Injunction Act
Whether the Anti- Injunction Act, which prohibits lawsuits “for the purpose of restraining the assessment or collection of any tax,” bars judicial challenge against the individual mandate? And whether the mandate is permissible under Congress’s powers to tax for the general welfare?
Nonetheless, the issue that will be getting the most attention is whether the individual mandate is a lawful exercise of Congressional power under the Commerce Clause. Under the Commerce Clause, Congress may pass laws that regulate the “channels of interstate Commerce,” “the instrumentalities of interstate commerce, and persons or things in interstate commerce,” and Congress may “regulate activities that substantially affect interstate commerce.” In passing the Affordable Care At, Congress found that the Health Care Law “regulates activity that is commercial and economic in nature: economic and financial decisions about how and when health care is paid for, and when health insurance is purchased.”
In support of the Health Care Law, the Government argues that “The minimum coverage provision is within Congress’s power to enact not only because it is a necessary component of a broader scheme of interstate economic regulation, but also because, within that scheme, it regulates economic conduct with a substantial effect on interstate commerce: the way in which individuals finance their participation in the health care market.”
The Government relies on Wickard v. Filburn, a 1942 Supreme Court decision where a farmer challenged the Agricultural Adjustment Act of 1938 which set limits on how much wheat a farmer could grow. Under the Health Care Law, a farmer, Roscoe Filburn, was forced to destroy his excess crop he had grown for personal consumption and pay a penalty. Despite the fact that Filburn was using the wheat for his own consumption, the Supreme Court upheld the law under the Commerce Clause, holding “Even if [Filburn’s farming of wheat] be local and though it may not be regarded as commerce, it may still, whatever its nature, be reached by Congress if it exerts a substantial economic effect on interstate commerce.”
Striking down the Affordable Care Act may unravel the entire Health Care Law and related regulations that have implemented over the past two years, and from which citizens have already begun to benefit. More importantly though, the Supreme Court’s decision on the Health Care Law will not only affect the health care system in the United States, but also affect the United States entire system of government, which has long relied on an expansive interpretation of the Commerce Clause. Striking down the Health Care Law would substantially restrict how Congress directs the national economy under the Commerce Clause in the future.
