CMSA Today - Issue 4, 2012 - (Page 25)
Case Management and the Law
Affordable Care Act and the U.S. Supreme Court
BY GARRY CARNEAL, JD, MA
s I write this column, the U.S. Supreme Court has just wrapped up oral arguments regarding the constitutionality of the Patient Protection and Aﬀordable Care Act (PPACA or Act). By the time you are reading this, the Justices have either just issued a ﬁnal decision or the ruling should be published just around the corner. The Court’s decision and reasoning will have far-reaching impact on the relationship between: 1) the health care system and the role of insurance; 2) the federal government and states; and 3) the federal government and U.S. citizens. The amount of time set aside for the U.S. Supreme Court oral hearings (i.e., over three days) and the energy behind the questioning during the oral arguments signal the gravity and importance of the case, and is without precedent in modern times. In addition, the decision pro or con could have an immense impact on the U.S. presidential election. Understanding the legal anatomy of this case is important both before and after the Court publishes its ruling. Here are the four central issues being decided by the Justices in order of the oral arguments that took place last March.
LEGAL ISSUE NO. 1: UNDERSTANDING THE TAX ISSUE
On March 26, the Justices heard oral arguments that centered on the issue of legal standing – speciﬁcally, whether the parties suing have the ability to bring the case before the U.S. Supreme Court at this point in time. At issue is whether or not the Anti-Injunction Act of 1867 eﬀectively renders the case moot, or premature, until a new tax goes into full eﬀect several years from now. The Fourth Circuit District Court in Richmond, VA, previously held that it lacked the authority to decide the constitutionality of the Aﬀordable Care Act based on the Anti-Injunction Act. Under PPACA’s legal language, many Justices questioned whether the penalty for an individual failing to purchase health insurance is, in fact, a tax. If PPACA’s individual mandate is considered a tax, then the legal proceedings would be delayed until 2014 or 2015 when tax takes eﬀect. After the oral arguments, most legal experts were predicting the Justices would dismiss this legal issue in order to rule on other issues detailed below sooner rather than later.
LEGAL ISSUE NO. 2: IS THE INDIVIDUAL MANDATE LEGAL?
On March 27, the Justices heard oral arguments that focused on the extent that the Commerce Clause of the U.S. Constitution delegates to the federal government the authority to regulate interstate commerce pursuant to PPACA’s individual mandate. More simply, can the federal government force someone to buy health insurance or pay a penalty if they don’t already participate in a plan? PPACA critics have argued that requiring individuals to purchase a good or service far exceeds congressional authority under the Commerce Clause, and that it opens the door to allow Congress to require individuals to buy a good as mundane as broccoli. Proponents of the Act have countered that the mandate is a valid use of congressional power to regulate interstate commerce and to implement a tax or penalty to help pay for health insurance.
As demonstrated by the inconsistent lower court rulings that led up the Supreme Court case, legal precedent appears to exist that can be used by both sides. The art of legal interpretation undoubtedly comes into play as the Justices extrapolate and analyze the facts from previous cases, along with established constitutional principles, to PPACA’s current set of facts. to include a “severability clause” in the ﬁnal draft of the bill before it was signed into law. For example, if the Court strikes down the individual mandate or any other central provision, the entire law may have to be overturned. Severability clauses generally provide that the balance of a law will remain in force in the event that any provision of a statute is declared unconstitutional or illegal.
LEGAL ISSUE NO. 3: CAN PART OR ALL OF PPACA BE STRUCK DOWN?
On the morning of March 28, oral arguments addressed the complex legal question of whether or not to strike down the entire Act if the Court ﬁnds part of the Act unconstitutional or illegal. This has become an important legal issue because Congress failed
ISSUE 4 • 2012 • DIGITAL
Table of Contents for the Digital Edition of CMSA Today - Issue 4, 2012
CMSA CORPORATE PARTNERS
EMBRACING THE GOLDEN AGE OF CASE MANAGEMENT
INCOMING PRESIDENT’S MESSAGE
CAREER AND KNOWLEDGE PATHWAYS: THE JOURNEY BEGINS
SERVANT LEADERSHIP: INSPIRATIONAL VALUES
WORKFORCE STRATEGY SIMPLIFIED
DIGITAL, MOBILE, GLOBAL: EFFICIENCIES AND HINDRANCES IN THE MODERN CASE MANAGER'S ENVIRONMENT
VIEW FROM CAPITOL HILL
CASE MANAGEMENT AND THE LAW
INDEX OF ADVERTISERS
CMSA Today - Issue 4, 2012