Affordable Care Act Legal Studies 101

Commerce Clause and the Affordable Care Act

The Affordable Care Act (ACA) of 2010 was signed into law on March 23, 2010 and a number of provisions have already gone into effect and still others are scheduled to be implemented over the next four years (Henry J. Kaiser Family Foundation sec. 2). Probably the most controversial provision is the requirement that Americans who chose not to purchase health insurance will be assessed an annual penalty for 'opting-out.' The so-called 'individual mandate' will be phased in over a period of three years, from 2014 to 2016, and individuals or families can 'purchase' the right to live without health insurance using a flat rate or percent income plan. The flat rate plan will increase over the three-year phase-in period and will eventually range from $695 to $2,085 per year. The percent income plan will increase from 1.0% in 2014 to 2.5% by 2016. Exemptions are provided for low-income individuals and families, Native Americans, undocumented immigrants, or anyone between jobs for less than three months.

The contention that the individual mandate wouldn't stir up considerable controversy, especially in a country that treasures individual freedoms, is simply dishonest (Tennant par. 1-3). President Obama's comparison of the individual mandate with state laws requiring drivers who license cars to purchase auto insurance seems reasonable on the surface, but a more detailed comparison can't withstand the scrutiny. Auto insurers can choose to refuse coverage to bad drivers or charge exorbitant rates, and no one is required to own and license an automobile. In contrast, all non-exempt citizens will be required to purchase qualified health coverage or pay a penalty. The option of not participating isn't available under ACA. For this...

Although most have been dismissed for lack of 'standing', a legal term used to denote whether the court has sufficient jurisdiction to hear a case, a few have gained traction in lower federal courts by individuals who claim current harm or that the provision is invalid on its face. Such issues will likely be decided by the U.S. Supreme Court.
Federal Court Structure

Individual claims of harm or injury due to an unconstitutional law are typically filed in the nearest district federal court, of which there are 94 in the United States. A district judge may decide the plaintiff has no standing and dismiss the case on those grounds or for other reasons, otherwise a hearing will be held. If the plaintiff dislikes the outcome they can appeal the decision to the relevant circuit court, of which there are 12. Should the appeal process produce an unfavorable outcome for the plaintiff, they then have the option of appealing (writ of certiorari) the decision to U.S. Supreme Court. The Supreme Court then decides whether to hear the case, which rarely happens, so lower court decisions are usually final.

The Search for Standing

States have had a hard time proving they have standing to challenge the ACA individual mandate provision. In Virginia v. Sebelius the 4th Circuit dismissed Virginia's claim because the ACA provision only affects individuals, not states (Stolzfus and Hall 2). These types of challenges will likely not be heard by the U.S. Supreme Court because it is considered settled jurisprudence that states can't sue on behalf of their citizens to protect them from federal law.

Another issue is the concept of 'ripeness', a term used to describe whether a plaintiff is jumping the gun by attempting to claim harm before harm has been incurred (Stolzfus and Hall 2). Courts have traditionally been reluctant to hear such cases, but some of the ACA challenges have bypassed this hurdle by claiming the individual mandate provision is invalid 'on its face'.

Concerns about the ripeness of ACA challenges by individuals may also fall under the jurisdiction of the Internal Revenue Service,…