Anesthesia Department Management: Patient Protection and Affordable Care Act
Author : Doc Clemens
The U.S. Supreme Court announced today it will hear a legal challenge to the Patient Protection and Affordable Care Act (PPACA), President Obama's health reform legislation Congress enacted in March 2010.
There are several issues before the Court. The most prominent is the law's mandate requiring individuals to purchase health insurance by 2014 if they do not otherwise have health care coverage through private insurers or public programs. This issue has been litigated in various courts to date. Three U.S. Circuits have found that the law is constitutional, or that the plaintiffs did not have standing to sue. One circuit court — the 11th Circuit — found that the individual mandate is unconstitutional. The Court also will hear arguments on whether the lawsuit challenging the individual mandate is barred by the tax anti-injunction act.
In addition, the Court granted review of whether PPACA's requirement that the states must increase their Medicaid coverage or risk forfeiture of federal Medicaid funding is unduly coercive. The Court had not been expected to take up this issue because no lower court had ruled in favor of the states on this point. If the Court accepts the states' arguments on this question, it could have far-reaching ramifications for other federal spending programs.
Oral arguments before the Court are expected in February or March, with a ruling by June. Obviously, the Court's decision could have a significant effect on the Presidential election in November. The Court has basically three options in deciding the individual mandate question:
- Rule that the individual mandate is a proper exercise of Congress' power under the Constitution to regulate interstate commerce, and thus the provision is constitutional
- Rule that the individual mandate is unconstitutional, but permit the other provisions in PPACA to be implemented as enacted
- Rule that the individual mandate is unconstitutional, and that the particular provision is so integral to the overall framework of PPACA that it cannot be severed from the law, and thus the entire legislation would be nullified
It is difficult to predict how the Court will rule. Whether a Justice is considered to be a "conservative" or a "liberal" is not, in and of itself, a reliable guide as to how the Justice will vote in this case. The Court has allocated 5½ hours for the arguments on the issues described above, an extraordinary amount of time that underscores the importance of this case