Second Federal Judge Declares Health Care Reform Law Unconstitutional

A second Federal District Court judge has declared the Affordable Care Act unconstitutional.

Adopting many of the same arguments that Judge Henry Hudson did in his decision in December, Federal Judge Roger Vinson in Florida issued a ruling today declaring the entirety of the Affordable Care Act unconstitutional:

A second federal judge ruled on Monday that it was unconstitutional for Congress to enact a health care law that requires all Americans to obtain commercial insurance, evening the score at two-to-two in the lower courts as the conflicting opinions begin their path to the Supreme Court.

Judge Roger Vinson of Federal District Court in Pensacola, Fla., ruled that the law will remain in effect until all appeals are concluded, a process that could take two years. However, Judge Vinson determined that the entire law should fall if appellate courts agree with his opinion that the insurance requirement is invalid.

“The Act, like a defectively designed watch, needs to be redesigned and reconstructed by the watchmaker,” Judge Vinson wrote.

In a 78-page opinion, Judge Vinson held that the insurance requirement exceeds the regulatory powers granted to Congress under the Commerce Clause of the Constitution. Judge Vinson wrote that the provision could not be rescued by an associated clause in Article I that gives Congress broad authority to make laws “necessary and proper” to carrying out its designated responsibilities.

“If Congress can penalize a passive individual for failing to engage in commerce, the enumeration of powers in the Constitution would have been in vain,” Judge Vinson wrote.

The judge’s ruling came in the most prominent of the more than 20 legal challenges mounted against some aspect of the sweeping health law, which was enacted last year by a Democratic Congress and signed by President Obama in March.

The plaintiffs include governors and attorneys general from 26 states, all but one Republican, as well as the National Federation of Independent Business, which represents small companies. Officials from six states joined the lawsuit just this month after shifts in party control brought by November’s midterm elections.

While Judge Vinison’s ruling comes to most of the same conclusions on the substantive issues in the case, he went further in one important way. Unlike Judge Hudson, Vinson also declined to sever the individual mandate from the rest of the ACA, and ended up declaring the entire law unconstitutional:

The existing problems in our national health care system are recognized by everyone in this case. There is widespread sentiment for positive improvements that will reduce costs, improve the quality of care, and expand availability in a waythat the nation can afford. This is obviously a very difficult task. Regardless of how laudable its attempts may have been to accomplish these goals in passing the Act, Congress must operate within the bounds established by the Constitution. Again, this case is not about whether the Act is wise or unwise legislation. It is about the Constitutional role of the federal government.

For the reasons stated, I must reluctantly conclude that Congress exceeded the bounds of its authority in passing the Act with the individual mandate. That is not to say, of course, that Congress is without power to address the problems and inequities in our health care system. The health care market is more than one sixth of the national economy, and without doubt Congress has the power to reform and regulate this market. That has not been disputed in this case. The principal dispute has been about how Congress chose to exercise that power here.

Because the individual mandate is unconstitutional and not severable, the entire Act must be declared void. This has been a difficult decision to reach, and I am aware that it will have indeterminable implications. At a time when there is virtually unanius agreement that health care reform is needed in this country, it is hard to invalidate and strike down a statute titled “The Patient Protection and Affordable Care Act.”

(…)

In closing, I will simply observe, once again, that my conclusion in this case is based on an application of the Commerce Clause law as it exists pursuant to the Supreme Court’s current interpretation and definition. Only the Supreme Court (or a Constitutional amendment) can expand that.

This is the fourth District Court opinion on the Affordable Care Act, and the second to declare it unconstitutional. In October, a Federal Judge in Michigan upheld the law’s constitutionality and his decision was quickly followed by a decision from a Federal Judge in Charlottesville, Virginia that upheld the law. Then, in December Judge Hudson issued his ruling declaring the law unconstitutional. The Michigan case is now pending in the 6th Circuit Court of Appeals and both of the Virginia cases have been consolidated by the 4th Circuit Court of Appeals and set on a briefing schedule that would probably put oral argument in that case on the calendar sometime in May of this year. Vinson’s ruling will also be appealed, of course, and it will end up before the 11th Circuit Court of Appeals. And, from there, all of these cases will head to the Supreme Court where, as I noted in December, the prospects for the arguments against the individual mandate do not look good at all.

So, stay tuned, because this story is far from over.

Florida et al v. HHS et al

FILED UNDER: Healthcare Policy, Law and the Courts, US Politics, , , , , , , ,
Doug Mataconis
About Doug Mataconis
Doug Mataconis held a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May 2010 and contributed a staggering 16,483 posts before his retirement in January 2020. He passed far too young in July 2021.

Comments

  1. Chad S says:

    SCOTUS might agree with the Hudson ruling, but their recent Commerce clause ruling doesn’t bode well for challenging Congress’ power to institute the individual mandate. Roberts just ruled in the last year on a challenge to Sarbanes-Oxley that an unconstitutional part of a law that doesn’t have severability doesn’t mean that the entire law is repealed.

    Imo, it will depend on the appeals court rulings. If they rule for the Individual mandate being constitutional, SCOTUS probably won’t hear the case so that they don’t have to rule on it.

  2. john personna says:

    This is getting to be quite the drama.

  3. IP727 says:

    difficult to imagine that a nation which began, at least in part, as the result of opposition to a British mandate giving the East India Company a monopoly and imposing a nominal tax on all tea sold in America would have set out to create a government with the power to force people to buy tea in the first place.

  4. IP727 says:

    ~ODE TO THE RULING~~~

    Their pucker strings are tightening,
    For them the future is frightening,
    The ditchcarp of the left are sniveling,
    As their tiny puds are shriveling,
    They are due a great enlightening

  5. sam says:

    “difficult to imagine that a nation which began, at least in part, as the result of opposition to a British mandate giving the East India Company a monopoly and imposing a nominal tax on all tea sold in America would have set out to create a government with the power to force people to buy tea in the first place.”

    See, Milita Act of 1797. And numerous federal programs requiring participants to purchase insurance, e.g., federal farm support acts; federal mandate to purchase flood insurance if your house is on a flood plain and the mortgage is backed by a federal agency, FHA, VA, etc. Federal mandates on citizens to purchase something are not unknown.

  6. sam says:

    Sorry, that should have been, Militia Act of 1792. And, yes, I know, this is under the militia clause, I was just responding to this would have set out to create a government with the power to force people to buy tea in the first place, reading ‘anything’ for ‘tea’.

  7. sam says:

    BTW, maybe Doug can write something on this, if he thinks it’s appropriate. It’s pretty interesting.

    The Ghost that Slayed the Mandate

    Abstract:
    Virginia v. Sebelius is a federal lawsuit in which Virginia seeks the invalidation of President Obama’s signature legislative initiative of healthcare reform. Virginia seeks declaratory and injunctive relief to vindicate a state statute declaring that no Virginia resident shall be required to buy health insurance. To defend this state law from the preemptive effect of federal law, Virginia contends that the federal legislation’s individual mandate to buy health insurance is unconstitutional. Virginia’s lawsuit is one of the most closely followed and politically salient federal cases in recent times. Yet neither the federal government nor any other legal commentator has previously identified the way in which the very features of the case that contribute to its political salience also require that it be dismissed for lack of statutory subject-matter jurisdiction. The Supreme Court has placed limits on statutory subject-matter jurisdiction over declaratory judgment actions in which a state seeks a declaration that a state statute is not preempted by federal law – precisely the relief sought in Virginia v. Sebelius. These limits insulate federal courts from the strong political forces surrounding lawsuits that seek federal court validation of state nullification statutes. This Essay identifies these heretofore neglected limits, shows why they demand dismissal of Virginia v. Sebelius, and explains why it is appropriate for federal courts to be closed to this type of suit.

  8. I find the notion that Commerce Clause objections to the individual mandate can render the entire bill unconstitutional to be curious, to put it mildly.

    Indeed, this strikes me very much as one judge trying to substitute his own judgment for that of the legislature–something conservatives usually call “legislating from the bench” (aka, “judicial activism”).

    I have a hard time thinking this ruling will stand, but then again I didn’t expect such a sweeping pronouncement in the first place.

  9. jpe says:

    @ Prof. Taylor: the idea is that, absent a severability clause, provisions of a law are presumed severable unless they’re so central to the law that it wouldn’t have passed but for the provision. The mandate was regularly touted as conceptually central to HIR (w/o it, reform wouldn’t work, proponents said), and as a political matter it’s easy to imagine the bill failing w/o it.

  10. jpe says:

    Let me follow up and clarify: I think the judge got the gist of the law on severability right, although it’s an open question whether the mandate is, in fact, so central to the law that it can’t stand w/o it.

  11. jpe says:

    @ sam: those mandates are always conditioned on some other federal power. Don’t want flood insurance? Don’t get a federal loan guarantee. The HIR mandate is conditioned on breathing alone.

  12. @jpe:

    It seems to me, however, that there are clearly portions of the bill (the extension of Medicaid, for example) that are clearly within Congress’ powers with or without the individual mandate.

  13. sam says:

    ” The HIR mandate is conditioned on breathing alone.”

    Ah, that’s where the eristics come in. It is true that some who oppose the mandate, as mandating based on some “activity/inactivity” distinction, allow that the government can mandate the purchase of X, if X is connected to some business activity, for example, farming and purchasing a home. Heath insurance is not like that, they argue (“is conditioned on breathing alone” is the short–but accurate– statement of that position). Some, like Judge Steeth in the Michigan decision, (implicitly) accept the must-be-connected-to-some-activity basis. Judge Steeth ruled that we all use or will use the medical care system, and therefore the mandate is constitutional (it’s connected to our use or potential use of the medical care system).

    Others, Orin Kerr, for instance, think all that activity/inactivity stuff is just that, stuff. (Basically, Orin thinks those who cleave to the distinction can’t make the distinction clear, or clear in such a way as to have legal weight). Folks who dismiss the activity/inactivity distinction as fatally indistinct, think the Congress can mandate the purchase of health insurance because of prior Supreme Court rulings (e.g., Gonzalez vs. Raich); Congress’ power to regulate the health care industry under the Commerce Clause; and Congress’ power to pass laws effecting such regulation under the Necessary and Proper Clause.

  14. Tlaloc says:

    Personally I’m hoping for the end result to be a strike down of the mandate but the retention of other parts of the law so that we can run insurance companies out of business and finally get the universal government run insurance we should have had a long time ago.

  15. Tlaloc, how dare you reveal the true intentions of the bill!

  16. Tsar Nicholas says:

    The law would have been phrased better had it not been drafted in the dead of night by a collection of airheaded malcontents, for whom the ink still was drying on their diplomas.

  17. ratufa says:

    Maybe the right thing for the government to do is not to force people to buy insurance but to amend EMTALA so that hospitals don’t have to provide emergency treatment to people without insurance. That should both satisfy all the folks who are unhappy about government mandates and provide some free-market incentives for those people who voluntarily don’t have insurance and are one accident away from being takers.

  18. Steve Plunk says:

    Legislating from the bench is what conservatives call it when judges make up new laws based upon today’s standards and morals. The reading of meaning that is not on the pages. What this judge did was rely on the Constitution’s clearly explicit limits on government. This was not taking an implied meaning but rather the written words of the Constitution.

    Let’s face a few other facts. The law is not popular and lacks the support of the people. It was written hastily and in secret. It carries with it to this day some unknown provisions yet to be worked out and certainly some unintended consequences. It simply makes a mockery of the legislating process and brings more disrepute upon our Congress. It cannot guarantee better health outcomes even after full implementation. It’s an experiment at the expense of the American people. Other than those things and a few others what’s wrong with it?

  19. An Interested Party says:

    “Tlaloc, how dare you reveal the true intentions of the bill!”

    I see…so the people behind the bill had the foresight to know that the individual mandate alone would be struck down, with the rest left in place, leading to the destruction of private insurance companies and the transition to real government-run health care? Quite a crafty crew of people who came up with this scheme…

  20. An Interested Party says:

    “Maybe the right thing for the government to do is…to amend EMTALA so that hospitals don’t have to provide emergency treatment to people without insurance.”

    Hmm…that would create some rather interesting news stories, with people literally dying in the streets…

    “The law is not popular and lacks the support of the people.”

    Actually, it’s more of a 50/50 kind of thing, but I understand why you would distort facts to make such a point…even if your “facts” were correct, and using your rationale…I’m sure many civil rights laws weren’t popular when they were first enacted…perhaps that was a reason to strike them down?

  21. tom p says:

    “so the people behind the bill had the foresight to know that the individual mandate alone would be struck down, with the rest left in place, leading to the destruction of private insurance companies and the transition to real government-run health care? ”

    Pure genious…

  22. Tano says:

    “The law is not popular and lacks the support of the people.”

    Simply not true. All the polls are completely consistent on this point – the significant majority of the American people support Obamacare, or something even more liberal (i.e having more of the problems that you decry).

    ” It was written hastily and in secret.”

    Are you a comedian or something? We ahd a long torturous national debate over every last detail of this bill. It went on for well over a year.

    “It carries with it to this day some unknown provisions yet to be worked out…”

    The provisions are not unknown. That they need to be “worked out” – i.e. have regulations written is true of just about every bill ever passed into law.

    “and certainly some unintended consequences. ”

    As do all human actions.

    “t simply makes a mockery of the legislating process and brings more disrepute upon our Congress. ”

    Yo may not like it, but this is exactly what democracy looks like. The only mockery of the process was the GOP playing the games of pretending support to move the bill rightward, then voting against it anyway.

    “It cannot guarantee better health outcomes even after full implementation.”

    Nothing in life is guaranteed. But the odds are very high, certainly higher than doing nothing.

    “It’s an experiment at the expense of the American people.”

    Once again, as can be said of any law.

    ” Other than those things and a few others what’s wrong with it?”

    Lacks a public option.

  23. anjin-san says:

    Well, if the mandate is tossed, the right can go back to whining about being forced to pay for the uninsured…

  24. jpe says:

    Judge Steeth ruled that we all use or will use the medical care system

    That’s a prediction of future interstate commerce, though, not actual interstate commerce. The moment that is interstate commerce is that moment in the future – which may or may not occur – when someone w/o insurance relies on emergency care.

    That’s the activity that can be regulated, not the failure to purchase insurance in the first place.

  25. jpe says:

    It seems to me, however, that there are clearly portions of the bill (the extension of Medicaid, for example) that are clearly within Congress’ powers with or without the individual mandate.

    That’s certainly right, and I think it gets to the two senses of “central” that I’ve seen kicked around here (to be honest, I’m a little too lazy to go into caselaw to confirm that both senses are operative). On the one hand is conceptual centrality; if we use that sense, certainly the mandate can be severed from the other provisions and broad portions of the law still makes sense (there are subjective and objective variants of that test, but I’ll pass on getting in that). On the other hand, there’s political centrality: did the Congress believe the law would’ve passed w/o this provision? That one’s quite a bit closer.

  26. Stan says:

    I think the Roberts court will invalidate the whole bill. If our newly elected Republican governors succeed in cutting the health benefits of public employees and of breaking the power of public employee unions, and if the present trend towards two-tier labor contracts continue, eventually the percentage of people without adequate health insurance will increase enough so that a new health insurance bill will pass that institutes a single payer system. That’s my guess. If I’m right,
    Judge Vinson will have won a Pyrrhic victory for his party.

  27. Steven Plunk says:

    Gentlemen, the fact is less than 50% support the overhaul in it’s current form. That’s not twisting facts at all. I see being put on the defensive riles up a few of you.

  28. An Interested Party says:

    “That’s not twisting facts at all.”

    Of course it is, as a good portion of those opposed to it actually want HCR to go further than it did…

    “I see being put on the defensive riles up a few of you.”

    Who knew that simply defending a position and asking questions was the same thing as being riled up…