Healthcare Reform at the Supreme Court

This morning, the Supreme Court granted review to three cases involving challenges to the Affordable Care Act. As a result, the political conversation on the American people's ability to address national issues via congressional legislation will be paralleled by a legal conversation at the nation's highest court.

The Court will address several specific legal issues:

  1. Does Congress have the constitutional authority under Article I to adopt the individual mandate, either under the Commerce Clause or under the Taxing Clause? With regard to the former, the Far Right has been pushing for a radical re-interpretation of the Commerce Clause to severely restrict congressional power to resolve national problems that cannot be resolved through individual or state action. In fact, the ACA fits perfectly with the text, intent, and history of the Commerce Clause.
  2. If the mandate is struck down, do all the other reforms in the law (like the requirement that insurance companies stop denying coverage to people with preexisting conditions) automatically fall with it, or is the mandate severable from the rest of the law? This is not a constitutional question but one of interpreting congressional intent in passing the ACA.
  3.  To what extent does the Constitution's Spending Clause let Congress attach conditions to federal grants to the states? The context here is the ACA's expansion of Medicaid eligibility.
  4. Do courts have jurisdiction to hear challenges to the individual mandate, or do they have to wait until 2015, when someone actually has to pay penalty for not having health insurance. This is a question of statutory interpretation involving a law called the Anti-Injunction Act, which generally prohibits courts from hearing challenges to levied taxes that have not yet been paid. The Court will address whether the penalty is a tax under the terms of that law.

SCOTUSBlog notes the significant amount of time the Court will be devoting to this issue:

The allotment of 5 1/2 hours for oral argument appeared to be a modern record; the most recent lengthy hearing came in a major constitutional dispute over campaign finance law in 2003, but that was only for 4 hours. The length of time specified for the health care review was an indication both of the complexity of the issues involved, and the importance they hold for the constitutional division of power between national and state governments. (In its earlier years, the Court customarily held days of oral argument on important cases; the modern Court, however, ordinarily limits oral argument to one hour per case.)

It is worth remembering that the individual mandate was a Republican idea. Their opposition to it today has nothing to do with constitutional principle, and everything to do with damaging President Obama politically and sabotaging the American people’s ability to effectively address national problems through national solutions.

PFAW