By: Roger Schwartz
As many of you have most likely heard or read already, a Federal District Court judge in Florida ruled yesterday that the individual mandate in the Affordable Care Act (ACA) “is unconstitutional and not severable,” and therefore that “the entire Act must be declared void.” State of Florida, et al, vs. United States Department of Health and Human Services, et al. The 26 states that were plaintiffs in this lawsuit claimed that in passing the individual mandate, Congress violated the Commerce Clause in the U.S. Constitution and that certain mandated Medicaid eligibility expansions in the ACA violated, among other things, the Spending Clause of the Constitution. Ironically, the court ruled against the states on its Medicaid claims but then held that the whole ACA was invalid since it concluded that the individual mandate was outside the Congress’s Commerce Clause power.
While this District Court ruling is a legal setback for the ACA and its provisions of health care reform, it does not have immediate implications and is a long way from halting this legislation. Particularly important, it should not slow down the critical provisions in the ACA that provide funding expansion to health centers. The District Court did not enjoin HHS from proceeding to implement the new law, and the federal government/HHS will no doubt appeal the Court’s legal conclusions. Other federal courts have concluded differently from the Florida judge, the Eleventh Circuit Court of Appeals will be dealing with an appeal from the Florida court decision, and other Courts of Appeals will be dealing with other (and future) lower court decisions on the legality of various provisions of the ACA. In short, it will likely be years before all of this gets sorted out—possibly by the Supreme Court. Meanwhile, there is every reason to assume that HHS will proceed to implement the health center and other provisions of the ACA—indeed; HHS is required legally to do so. Health centers, networks, and PCAs should continue to apply for, and fully utilize, available ACA funding for New Access Points, Service Expansions, planning grants, capital projects, and other uses without fear that the funding may be taken back at some future point. NACHC will continue to keep you up informed on developments in court actions relating to the ACA.