Three Outcomes of Florida vs. DHHS

For the last few weeks most of the focus on the Supreme Court has been surrounding the case of Florida v. United States Department of Health and Human Services. This is the case challenging the constitutionality of the Patient Protection and Affordable Care Act, commonly called “Obamacare.”

The act was signed by President Obama on March 23, 2010. Several States have passed various forms of legislation in an attempt to nullify the law. The State of Florida filed a lawsuit. On January 31, 2011 U.S. District Judge Roger Vinson ruled that Congress violated the Constitution by requiring Americans to buy insurance as part of the health overhaul passed last year, and said the entire law “must be declared void.” On August 12, 2011, the Eleventh Circuit Court of Appeals affirmed Judge Vinson’s decision in part; the divided three judge panel agreed that the mandate was unconstitutional, but held that it could be severed, allowing the rest of the PPACA to remain. The DHHS appealed to the Supreme Court which will answer the following questions:
1. 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 Dakota v. Dole, 483 U.S. 203 (1987), no longer apply?
2. May Congress treat States no differently from any other employer when imposing invasive mandates as to the manner in which they provide their own employees with insurance coverage, as suggested by Garcia v. San Antonio Metropolitan Transit Authority, 469 U.S. 528 (1985), or has Garcia’s approach been overtaken by subsequent cases in which this Court has explicitly recognized judicially enforceable limits on Congress’s power to interfere with state sovereignty?
3. 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?

An amicus brief filed by sixteen groups and individuals including the Downsize DC Foundation states, PPACA “is a remarkable law, not just imposing plenary federal control over the private health insurance industry and health care practices, but also placing the federal government into that business and practice. Purporting to be an exercise of Congress’ Commerce Clause power, this law goes beyond any prior Congressional exercise of the Commerce power, mandating that individuals purchase private insurance, overriding any religious, moral, or practical scruples that they may have.”

Though, the court will essentially provide one of three decisions with the following outcomes.
1. The court rules the PPACA to be constitutional, which could also provide precedent for the Congress to pass any number of additional laws to control every aspect of your life.

2. The court rules the individual mandate to be unconstitutional and retains the remaining aspects of the law. In this scenario since the precedent has been set for States to mandate individuals purchase health insurance, Congress could pass legislation forcing States to implement an individual mandate at the State level.

3. The court rules the entirety of PPACA is unconstitutional. However, the precedent has been set that States may require the purchase of health insurance, subsidize those who can’t afford it and penalize those who don’t buy it. Additionally the precedent has been set that Congress can force States to implement legislation. So, even if the Supreme Court rules PPACA to be unconstitutional, the Congress could theoretically require every State adopt a law similar to the Massachusetts Health Reform law.