Florida v. United States Department of Health and Human Services is a lawsuit filed in the United States District Court for the Northern District of Florida by the State of Florida against the United States Department of Health and Human Services seeking to nullify the Patient Protection and Affordable Care Act (PPACA) (part of the United States' 2010 changes to health care) as unconstitutional. On January 31, 2011, U.S. District Judge Roger Vinson ruled that the health insurance mandate in section 1501 falls outside the federal authority in the Constitution, and that the provision could not be severed; Judge Vinson therefore concluded the entire PPACA must be struck down. On August 12, 2011, a divided three-judge panel of the Eleventh Circuit Court of Appeals affirmed Judge Vinson's decision in part; the panel agreed that the mandate was unconstitutional, but held that it could be severed, allowing the rest of the PPACA to remain. The federal government declined to seek an en banc review by the Eleventh Circuit and instead petitioned for the U.S. Supreme Court to review the panel's ruling. On November 14, 2011, the Supreme Court granted certiorari on the case, setting oral arguments for March 2012.
The case was brought by Florida attorney general Bill McCollum on March 23, 2010, hours after the PPACA was signed into law. Joining McCollum were the attorneys general of 12 other states: South Carolina, Nebraska, Texas, Utah, Louisiana, Alabama, Michigan, Colorado, Pennsylvania, Washington, Idaho and South Dakota.
More states join the lawsuit
On January 19, 2011, the same day the House voted to repeal the law, new Florida Attorney General Pamela Bondi (R) filed a motion in Pensacola federal court to add six new states to the lawsuit, including Maine, Wisconsin, Ohio, Kansas, Iowa and Wyoming.
The amended complaint currently features 26 state plaintiffs; additionally, the National Federation of Independent Business (NFIB) joined the lawsuit early on as a co-plaintiff on behalf of its members nationwide.
In September 2009, Washington lawyers David B. Rivkin Jr. and Lee Casey of Baker Hostetler wrote a series of op-eds on the constitutionality of the health-care law in The Wall Street Journal that caught the attention of McCollum. According to Florida deputy Attorney General Joe Jacquot, the pieces "sparked conversation throughout Mr. McCollum's office on 'state sovereignty and the individual mandate' the portion of the law that requires all individuals to purchase health insurance".
The lawsuit challenges the constitutionality of the "individual mandate", and also challenges Medicaid expansion, which opponents believe will sink already struggling state budgets.
Two federal judges appointed by President Bill Clinton upheld the individual mandate in 2010; but a federal judge in Virginia, who was appointed by President George W. Bush, struck down the individual mandate in December of 2010, although he declined to block the law's implementation.
The Wall Street Journal called the lawsuit "the most closely watched case in the ongoing political battle over the health-care overhaul".
Court decisions in the case
On October 14, 2010, U.S. District Judge Roger Vinson ruled that the U.S. states could proceed with the lawsuit to overturn the new health care reform law. David Rivkin was hired to represent the plaintiffs. He argued that if the government could regulate individual decisions to not purchase health insurance there could be no meaningful limits on federal power. "Congress can regulate commerce," he said. "But Congress cannot create it."
The government countered that "decisions to not buy insurance, taken in the aggregate, have a direct effect on commerce because uninsured people still consume health care, and often cannot pay; that uncompensated care is subsidized by others and drives up costs for hospitals, governments and privately insured individuals."
Vinson dismissed four of six claims the states brought against the health care law but said he saw grounds to proceed on two counts, including one relating to the way critics say it would force huge new spending by state governments. On the issue of the so-called "individual mandate", the law's provision that all Americans obtain health care insurance, Vinson said the plaintiffs had "most definitely stated a plausible claim" for their objections, noting that "the power that the individual mandate seeks to harness is simply without prior precedent".
According to The Wall Street Journal, Vinson "also noted the difference between regulating an economic activity and attempting to regulate an economic non-activity. Most Commerce Clause cases deal with the former, not the latter." Vinson was quoted as saying:
On December 16, 2010, Judge Vinson heard oral arguments, days after a Virginia judge ruled that the federal government was overstepping its boundaries by requiring Americans to carry health insurance by 2014.
Plaintiffs, led by outside counsel Rivkin, argued that expansion of Medicaid would overwhelm state budgets; they also argued "the mandatory coverage provision exceeds the legislative authority of the U.S. Congress to regulate interstate commerce by attempting to control the inaction of the uninsured."
Government lawyer Ian Heath Gershengorn countered that the $2.5 trillion national health care market was unlike anything else; that those who weren't purchasing insurance were making the economic decision to pay later or shift the cost (the "uninsured are not inactive this is not a situation of innocent bystanders standing to the side").
In a Wall Street Journal article, Rivkin called the law "in its design, the most profoundly unconstitutional statute in American history; in its execution, one of the most incompetent ones".
On January 31, 2011, Judge Vinson issued an opinion finding that:
Medicaid expansion is not coercive to the States
- Failing to buy health insurance is not an act of interstate commerce
- The Necessary and Proper Clause does not allow Congress to impose an individual mandate, and
- The individual mandate is not severable from the rest of PPACA.
In summary, Vinson stated "Because the individual mandate is unconstitutional and not severable, the entire Act must be declared void." This decision invalidates not only the requirement of purchasing health care, but the entire Act as signed. The Justice Department expressed its intention to file an appeal with the 11th Circuit Court of Appeals.
In publishing his opinion, Vinson did not grant an injunction barring implementation of the Act, stating that such a step is unnecessary because there is a "long-standing presumption" that the federal government would adhere to such a ruling without need for an injunction. However, a senior White House official stated that, in the absence of an injunction, "implementation will proceed apace".
Eleventh Circuit decision
On August 12, 2011, a divided three-judge panel of the Eleventh Circuit Court of Appeals affirmed Judge Vinson's decision in part: the court agreed that the mandate was unconstitutional, but held that it could be severed, allowing the rest of the PPACA to remain.
On September 26, 2011, it was reported that the Department of Justice would not ask for an en banc review by the 11th U.S. Circuit Court of Appeals. This means the U.S. Supreme Court heard the case in March 2012 and will rule in the midst of the 2012 election season. On November 14, 2011, the Supreme Court granted certiorari to portions of three cross-appeals of the Eleventh Circuit's opinion: one by the states (Florida v. U.S. Dept. of Health and Human Svcs.), one by the federal government (U.S. Dept. of Health and Human Svcs. v. Florida); and one by the NFIB (Nat'l Fed. of Independent Bus. v. Sebelius). The Court narrowed the questions to be addressed to:
- Whether Congress had the power under Article I of the Constitution to enact the minimum coverage provision.
- Does PPACA's mandate that virtually every individual obtain health insurance exceed Congress's enumerated powers and, if so, to what extent (if any) can the mandate be severed from the remainder of the Act?
- Does Congress exceed its enumerated powers and violate basic principles of federalism when it coerces States into accepting onerous conditions that it could not impose directly by threatening to withhold all federal funding under the single largest grant-in-aid program, or does the limitation on Congress's spending power that this Court recognized in South Dakota v. Dole no longer apply?
- Whether the Anti-Injunction Act bars the pre-enforcement challenge by the respondent's to the minimum coverage provision of the PPACA?
The Court announced in December 2011 that it will hear approximately six hours of oral argumentation over a three-day period, from Monday, March 26 to Wednesday, March 28, 2012, covering the various aspects being questioned by the principal parties involved in this and other related cases concerning the PPACA.
- Patient Protection and Affordable Care Act Cases
- Health care reform in the United States
Wickard v. Filburn, 317 U.S. 111 (1942)
Schechter Poultry Corp. v. United States, 295 U.S. 495 (1935)
- Anti-Injunction Act (1867)