On June 28, 2012, the United States Supreme Court issued its opinion about regarding the constitutionality of the Affordable Care Act (ACA). In a case known as National Federation of Independent Business v. Sebelius, the Court agreed to consider the constitutionality of two major provisions of the ACA: the individual mandate and the Medicaid expansion. A majority of the Court upheld the individual mandate. And, while the Court found the Medicaid expansion unconstitutionally coercive of states, because states did not have adequate notice to voluntarily consent and the Secretary could potentially withhold all of a state’s existing federal Medicaid funds for non-compliance, a majority of the Court found that this issue was appropriately remedied by circumscribing the Secretary’s enforcement authority, thus leaving the Medicaid expansion intact in the ACA. A policy brief recently released by the Kaiser Family Foundation describes the Court’s decision and looks ahead to the implementation of health reform now that the constitutionality of the ACA has been resolved.
September 27, 2012
President Barack Obama and former Massachusetts Governor Mitt Romney released essays
in the New England Journal Medicine (NEJM) presenting their visions for the future of health care reform. Obama calls for additional steps to fix the nation's health care delivery system, including a "permanent fix to Medicare's flawed payment formula that threatens physicians’ reimbursement.” President Obama also pledges his commitment to life sciences research, distancing himself from vice presidential candidate Paul Ryan's proposal to slash medical research investments. Obama also touts various popular Affordable Care Act (ACA) provisions including the end of lifetime benefit caps, expanded preventive care services coverage, permitting young adults to remain on their parents insurance until age 26, rebates from insurance companies from the medical loss ratio (MLR) provision, and the efforts to reduce Medicare and Medicaid fraud. Romney touches on his premium support plan for Medicare, Medicaid block grants, and plan to prevent discrimination against patients with pre-existing conditions "who maintains continuous coverage."
July 26, 2012
Two new reports, released by the New England Journal of Medicine, analyze the impact of Medicaid expansion under the Affordable Care Act (ACA). "The Supreme Court and the Future of Medicaid," authored by Timothy Stoltzfus Jost and Sara Rosenbaum, reviews both the Supreme Court’s majority and dissenting Medicaid expansion arguments and addresses three outstanding questions regarding the ruling.
On June 28th...
July 2, 2012
HealthReformGPS Editor, Sara Rosenbaum, and frequent guest contributor to HealthReformGPS, Timothy Jost, authored two Health Affairs pieces analyzing the Supreme Court's Thursday decision regarding the Affordable Care Act (ACA). Jost's post provides
an overview of the Court's decision regarding the individual mandate while Rosenbaum's examines
the Court's surprising Medicaid expansion ruling.
June 28, 2012
The Supreme Court handed down its long-awaited ruling in the case of National Federation of Independent Businesses et al. v. Sebelius, Secretary of Health and Human Services, et al., upholding the individual requirement to maintain insurance coverage as a reasonable exercise of Congress’s taxing and spending authority and also upholding the constitutionality of the Medicaid coverage expansion. In a surprise coalition, Chief Justice Roberts was joined in his majority opinion by Justices Stephen Breyer, Ruth Bader Ginsburg, Sonia Sotomayor and Elena Kagan. The summary below describes the majority opinion, the concurring opinion (authored by Justice Ginsburg), and the dissenting opinion (written by Justice Scalia). Because the Court upheld the individual mandate, it never reached...
October 12, 2011
On September 28, 2011, the United States Justice Department (DOJ) asked the United States Supreme Court to review the decision of the court of appeals for the Eleventh Circuit striking down as unconstitutional what the DOJ terms the law’s “minimum coverage provision.” In seeking Supreme Court intervention, the DOJ sought review on two matters: first, whether Congress exceeded its Commerce Clause powers, as enhanced by the Necessary and Proper Clause; and second, whether the Anti-Injunction Act bars the challenges from proceeding in the first place.
September 23, 2011
Since the enactment of the Affordable Care Act (ACA), at least 27 lawsuits have been filed challenging the constitutionality of various provisions of the law. While nearly half of the lawsuits have been dismissed on procedural grounds, three district courts have found provisions challenged to be constitutional, and three have found them to be unconstitutional. Previous HealthReform GPS Implementation briefs/updates have discussed these lower court decisions. Following appeals of each of these rulings, the United States Courts of Appeals in the Fourth, Sixth, and Eleventh Circuits have now issued decisions as well. Most importantly, the appellate decisions continue to reflect a split in judicial opinion regarding the constitutionality of the Affordable Care Act’s individual mandate. Other important issues addressed by the appellate rulings concerned the constitutionality of the ACA Medicaid expansion and the question of whether the trial court in the Virginia cases (Liberty University v. Geithner and Commonwealth of Virginia v. Sebelius) had the authority to hear the cases at all.
December 14, 2010
This is an updated version of a brief originally published on November 15, 2010.
Shortly after President Obama signed the Patient Protection and Affordable Care Act (ACA) into law, opponents of the law filed a series of legal challenges in federal court. This health reform implementation brief provides an overview of the legal challenges by identifying and providing summaries of the two major cases filed by states and select claims, not raised by the states, from other cases.