Supreme Court to Review Health Care Reform Law

By Joe Carlson

Nov. 14, 2011

The Supreme Court announced it will review whether Congress has the power to compel nearly all Americans to purchase health insurance or face a tax penalty and whether the federal government’s effort to expand state Medicaid programs amounts to illegal coercion.

In a regular order posted on its website on Nov. 14, the court announced that it would hear oral arguments on a total of four specific questions raised in federal circuit court decisions that split on the legality of the so-called individual mandate to buy insurance in the Patient Protection and Affordable Care Act.

A spokesman for the Supreme Court said that the health care reform cases were likely to be argued sometime next March. Observers have said that decisions for cases argued in the court’s spring term would likely by published by June, which could thrust the case into the national run-up to the November 2012 presidential election.

The reform law compels most private citizens to buy health insurance by 2014 or face a tax penalty on their income taxes, which has emerged as the key issue in critics’ nation-wide challenge of the reform law. That requirement was struck down by the 11th Circuit Court of Appeals in Atlanta, whose ruling was appealed to the Supreme Court by the Obama administration.

The National Federation of Independent Business, meanwhile, was granted oral arguments on a finding in the same ruling that said although the mandate was unconstitutional, it can be severed, allowing the remainder of the reform law to stand. The NFIB argues the whole law should be struck down.

Finally, the Supreme Court ordered arguments on the question of whether any challenge to the individual mandate can be entertained by a court now.

The 4th Circuit Court of Appeals in Richmond, Virginia, has ruled that the mandate is a tax, because it is included in the IRS tax code, and therefore can’t be challenged in court until after 2014, when the tax penalties kick in for failing to buy insurance.

The high court also agreed to hear an appeal filed by 26 states arguing that the reform law’s expansion of the Medicaid program amounted to illegal coercion by the federal government. That case was considered less likely by some legal scholars to hear an argument in the Supreme Court because no appeals court has yet sided with the coercion argument.

The questions granted are:

Petition 11-393: NFIB v. Sebelius (PDF) – “The question presented is whether the ACA must be invalidated in its entirety because it is nonseverable from the individual mandate that exceeds Congress’ limited and enumerated powers under the Constitution”

Petition 11-400: Florida v. HHS (PDF) – “Does the Affordable Care Act’s mandate that virtually every individual obtain health insurance exceed Congress’s enumerated powers and, if so, to what extent (if any) can the mandate be severed from the remainder of the Act?”

Petition 11-398: HHS v. Florida (PDF) – “Whether Congress had the power under Article 1 of the Constitution to enact the minimum coverage provision.” And, “Whether the suit brought by respondents to challenge the minimum coverage provision of the Patient Protection and Affordable Care Act is barred by the Anti-Injunction Act?”

Petition 11-400: Florida v. HHS – “Does Congress exceed its enumerated powers and violate basic principles of federalism when it coerces States into accepting onerous conditions that it could not impose directly by threatening to withhold all federal funding under the single largest grant-in-aid program, or does the limitation on Congress’s spending power that this Court recognized in South?”

Joe Carlson writes for Modern Healthcare, a sister publication of Workforce Management. To comment, email


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