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U.S. Department of Health & Human Services v. Florida

CAC has defended the constitutionality of the Patient Protection and Affordable Care Act since it was first challenged in 2010.  Representing a group of state legislators that grew to include more than 500 legislators from all 50 states, CAC filed briefs supporting the Act’s constitutionality in the federal district court, appellate court, and the U.S. Supreme Court, which ultimately upheld the Act.

On November 19, 2010, CAC filed a brief in the case on behalf of a bipartisan group of 78 State Legislators from 27 States, supporting the federal government’s argument that the Patient Protection and Affordable Care Act is constitutional and that summary judgment should be granted in its favor. The group of Legislators represented by CAC included state Representatives and Senators from across America, many standing in opposition to the efforts of their own state’s Attorney General or Governor to overturn health care reform in court.

As CAC’s brief filed on behalf of the State Legislators showed, the Constitution creates a vibrant system of federalism that gives broad power to the federal government to act in circumstances in which a national solution is necessary or preferable, while reserving a significant role for the States to craft innovative policy solutions that showcase the diversity of America’s people, places, and ideas. Far from violating state sovereignty or the principles of federalism in our Constitution, the health care reform law respects the federal-state partnership and builds upon it.

As CAC’s brief further demonstrated, the conservative state Attorneys General and their allies’ constitutional claims regarding the Act’s expansion of Medicaid—which helps the Act achieve expanded coverage, lower costs, and health insurance security for millions of Americans—are groundless. States cannot be “coerced” or “commandeered” into complying with the new Medicaid requirements for the simple reason that Medicaid is and always has been a wholly voluntary partnership. States are free to opt out and create their own state alternative at any time.

On January 31, 2011, Judge Roger Vinson issued a ruling in Florida v. HHS rejecting the constitutional claims regarding the Act’s expansion of Medicaid, as we had urged. However, Judge Vinson went on to rule that the minimum coverage provision of the Act (referred to by some as the “individual mandate”) is unconstitutional, held that this provision could not be severed from the rest of the health care reform law, and proceeded to issue a declaratory judgment striking down the law in its entirety. According to Judge Vinson, Congress lacked the constitutional authority, including under the Commerce Clause, to adopt the minimum coverage provision.  This ruling was appealed to the Eleventh Circuit.

On April 8, CAC filed a brief in the appellate court, supporting the government's appeal and continuing to defend the constitutionality of the health care reform law. The Eleventh Circuit heard oral argument in the federal government's appeal of Judge Vinson’s ruling on June 8.  On August 12, a divided panel of the Eleventh Circuit upheld Judge Vinson’s ruling striking down the Act’s minimum coverage provision. Read CAC’s press release blasting the decision here.

On September 28, the Obama Administration petitioned the Supreme Court for review of the decision. On November 14, 2011, the Supreme Court granted review in the case.  CAC filed two separate briefs demonstrating that the text and history of the Constitution support the constitutionality of both the ACA’s “minimum coverage provision” and its Medicaid expansion.  Our reaction to the oral arguments is here.

On June 28, 2012, the Supreme Court upheld the Affordable Care Act in a huge victory for the landmark legislation and the rule of law. Chief Justice John Roberts broke with the Court’s conservative wing to uphold the Act in a 5-4 decision. Justice Ruth Bader Ginsburg, writing separately to express her disagreement with portions of the Chief Justice’s opinion, made a powerful case for the constitutional text and history behind Congress’s power to enact the law, citing a resolution from the Constitutional Convention that was described in CAC’s brief to the Court.  Read CAC’s statement on the ruling here.