Supreme Court Consideration of the Affordable Care Act Key Issues - - PowerPoint PPT Presentation

Supreme Court Consideration of the Affordable Care Act

Key Issues Under Consideration

Katherine Hayes, JD Associate Research Professor March 04, 2012

Four Questions

• Is the minimum coverage requirement

Constitutional?

• If minimum coverage requirement is

unconstitutional, can it be severed from the remainder of the ACA?

• Are the Medicaid provisions coercive?
• Does the Anti-Injunction Act bar federal court

consideration of the minimum coverage provision.

Minimum Coverage

• Commerce Clause

– Substantial affect on interstate commerce

• Necessary and Proper Clause

– Commerce Clause regulation of insurance – Requirement is “necessary” to maintain insurance market reforms

• Taxing and Spending Authority

– Penalty v. tax

Severability

• If found unconstitutional, can the minimum

coverage provision be “severed” from the ACA, leaving the remainder intact?

• Impact on insurance market if no minimum

coverage requirement?

• If not severable, how much should be struck

down?

– Insurance market reforms? – Employer requirement?

Medicaid Coercion

• Requires states to cover individuals with

incomes under 133 percent of FPL effective January 1, 2014

• Is the requirement “an offer states can’t

refuse?”

• First time Congress requires all or nothing

approach?

• Implications for other federal programs?

Anti-Injunction Act

• Constitution permits Congress to regulate

federal court jurisdiction

• Prohibits “pre-enforcement” litigation which

has the purpose of blocking implementation of a tax.

• Is it a tax or a penalty?
• What is the purpose of the minimum coverage

challenge?

Conclusion

• Timing

– Consideration – Decision issued

• What next?