Are State Challenges to the Legality of the Patient Protection and Affordable Care Act Likely to Succeed?

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Document date: June 22, 2010
Released online: June 23, 2010


Attorneys general in Florida and Virginia, along with their counterparts in 19 other states, have sued to block implementation of the Patient Protection and Affordable Care Act (PPACA). They claim its mandate to obtain health insurance is unconstitutional. PPCA supporters say the mandate is a valid exercise of federal authority. This brief examines the officials’ arguments against PPACA and concludes the mandate rests on firm legal footing but has two vulnerabilities: (1) the Supreme Court could set new precedent and (2) enforcement provisions must be strengthened to preserve the government’s ability to ensure insurance coverage.

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Can the federal government require individuals to have health coverage? During congressional health reform debates, opponents occasionally claimed that such a mandate is unconstitutional. Supporters countered that the individual mandate is an integral part of health insurance reform, and is supported by clear authority to regulate interstate commerce and to enact federal taxes. Since enactment, attorneys general in Florida and Virginia have sued in federal court to block implementation of the Patient Protection and Affordable Care Act (PPACA). The suit in Florida has been joined by officials from numerous other states. The act’s opponents see courts as their “last line of defense,” as noted by a headline in congressional news daily The Hill.

In lay terms, there are three main legal arguments against PPACA: First, once implemented, reform will unconstitutionally compel individuals to buy insurance who don’t want it. Second, starting immediately, federal reform unconstitutionally makes states administer and support expansions. Third, PPACA will ultimately make the federal government too powerful, threatening unlimited federal control over American life, and constitutional interpretation needs to stop such expansion.

Do either individuals or states have a strong constitutional argument against health reforms? The short answer is no, particularly not the state challengers. A longer answer is that the Constitution ultimately means what the Supreme Court says it means, and that even seemingly settled interpretations of constitutional law are subject to its rare paradigm shifts—which is what the third argument appears to seek. Another answer is that these legal arguments may seek more to influence the political climate of enforcement than the judicial review of PPACA.

(End of excerpt. The full brief is available in PDF format.)

Topics/Tags: | Health/Healthcare

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