Constitutional challenges to the Affordable Care Act

Some organizations and lawmakers who opposed the passage of the ACA took legal action following its passage. Several court challenges involved attempts to invalidate key provisions of the ACA. As of July 2013, none of these challenges had succeeded.

File:PPACA States Lawsuit.svg

Twenty-eight states filed joint or individual lawsuits (including 26 states engaged in a joint action) to strike down the ACA's individual mandate.{{cite news |url=http://www.teamiha.org/Documents/IHANews/0318%20Medical%20insurance%20refusal.pdf |title=Otter is the first governor to sign a law saying the state will defy a requirement to buy insurance |newspaper=Idaho Statesman |access-date=March 22, 2010 |date=March 18, 2010 |author=Murphy, Brian |archive-url=https://web.archive.org/web/20111230204135/http://www.teamiha.org/Documents/IHANews/0318%20Medical%20insurance%20refusal.pdf |archive-date=December 30, 2011 |url-status=dead }}{{cite news |url=https://www.usatoday.com/news/nation/2010-03-23-attorneys-general-health-suit_N.htm |title=13 attorneys general sue over health care overhaul |agency=Associated Press |author=Farrington, Brendan |date=March 23, 2010 |access-date=May 14, 2010 |work=USA Today |archive-date=March 26, 2010 |archive-url=https://web.archive.org/web/20100326145310/http://www.usatoday.com/news/nation/2010-03-23-attorneys-general-health-suit_N.htm? |url-status=live }} In a press release, the Attorneys General for several states indicated their primary basis for the challenge was a violation of state sovereignty. Their release repeated the claim challenging the federal requirement under threat of penalty, that all citizens and legal residents have qualifying health care coverage. It also claimed that the law puts an unfair financial burden on state governments. The lawsuit states the following legal rationale: {{blockquote|Regulation of non-economic activity under the Commerce Clause is possible only through the Necessary and Proper Clause. The Necessary and Proper Clause confers supplemental authority only when the means adopted to accomplish an enumerated power are 'appropriate', are 'plainly adapted to that end', and are 'consistent with the letter and spirit of the constitution.' Requiring citizen-to-citizen subsidy or redistribution is contrary to the foundational assumptions of the constitutional compact.Case 3:10-cv-00188-HEH, Document 1. Page March 5, 23, 2010.}}

Other states were either expected to join the multi-state lawsuit or are considering filing additional independent suits.Richey, Warren (March 23, 2010), [http://www.csmonitor.com/USA/Justice/2010/0323/Attorneys-general-in-14-states-sue-to-block-healthcare-reform-law "Attorneys general in 14 states sue to block healthcare reform law"], The Christian Science Monitor, Retrieved March 24, 2010Funk, Josh (March 22, 2010). [http://journalstar.com/news/local/govt-and-politics/article_cdf483b6-35c9-11df-a053-001cc4c03286.html "AG Bruning says health reform violates Constitution"] {{Webarchive|url=https://web.archive.org/web/20110917223332/http://journalstar.com/news/local/govt-and-politics/article_cdf483b6-35c9-11df-a053-001cc4c03286.html |date=September 17, 2011 }}. Lincoln Journal Star. Retrieved 2010-03-23. Members of several state legislatures are attempting to counteract and prevent elements of the bill within their states. Legislators in 29 states have introduced measures to amend their constitutions to nullify portions of the health care reform law. Thirteen state statutes have been introduced to prohibit portions of the law; two states have already enacted statutory bans. Six legislatures had attempts to enact bans, but the measures were unsuccessful.{{cite web |url=http://www.ncsl.org/?tabid=18906 |title=State Legislation Opposing Certain Health Reforms, 2009–2010 |publisher=National Conference of State Legislatures |access-date=March 23, 2010 |author=Cauchi, Richard}} In August 2010, a ballot initiative passed overwhelmingly in Missouri that would exempt the state from some provisions of the bill. Many Missouri legal analysts expect that the measure will be struck down if challenged in Federal court.{{cite web |last=Messenger |first=Tony |title=Prop C passes overwhelmingly |url=http://www.stltoday.com/news/local/govt-and-politics/article_c847dc7c-564c-5c70-8d90-dfd25ae6de56.html |date=August 4, 2010 |access-date=August 19, 2016 |archive-date=March 7, 2017 |archive-url=https://web.archive.org/web/20170307131054/http://www.stltoday.com/news/local/govt-and-politics/article_c847dc7c-564c-5c70-8d90-dfd25ae6de56.html |url-status=live }}

In February 2011, Alexander Bolton wrote in The Hill that consensus among legal experts largely changed following Judge Roger Vinson's decision in Florida et al v. United States Department of Health and Human Services. Bolton said that prior to the ruling, it was widely felt that the Supreme Court would uphold the law by a comfortable margin, but now legal scholars generally feel it would be a 5–4 decision. Georgetown University Law Center professor Randy Barnett said, "There's been a big change in the conventional wisdom ... the temperature of law professors has changed considerably," and described the Florida decision as "extremely deep in its discussion of principles and constitutional doctrine".{{cite news |last=Bolton |first=Alexander |title=Lawmakers press Supreme Court for verdict on healthcare law |url=https://thehill.com/homenews/administration/81494-lawmakers-press-supreme-court-for-verdict-on-healthcare-law/ |access-date=July 17, 2011 |newspaper=The Hill |date=February 2, 2011}}

On January 31, 2011, Judge Roger Vinson in Florida v. United States Department of Health and Human Services declared the law unconstitutional in an action brought by 26 states, on the grounds that the individual mandate to purchase insurance exceeds the authority of Congress to regulate interstate commerce. Vinson further ruled the clause was not severable, which had the effect of striking down the entire law.{{cite web |last=Brown |first=Tom |url=https://www.reuters.com/article/us-usa-healthcare-ruling-idUSTRE70U6RY20110131 |title=Judge strikes down healthcare reform law |publisher=Reuters.com |date=January 31, 2011 |access-date=June 29, 2012 |archive-date=January 17, 2016 |archive-url=https://web.archive.org/web/20160117041104/http://www.reuters.com/article/us-usa-healthcare-ruling-idUSTRE70U6RY20110131 |url-status=live }}{{cite web |author=David Whelan |url=https://blogs.forbes.com/davidwhelan/2011/01/31/breaking-news-florida-judge-rules-against-obamacare-individual-mandate-unconstitutional/ |title=Florida Judge Rules Against ObamaCare, Calls Individual Mandate Unconstitutional |publisher=Blogs.forbes.com |date=April 18, 2012 |access-date=June 29, 2012 |archive-date=August 5, 2011 |archive-url=https://web.archive.org/web/20110805153657/http://blogs.forbes.com/davidwhelan/2011/01/31/breaking-news-florida-judge-rules-against-obamacare-individual-mandate-unconstitutional/ |url-status=live }}

On August 12, 2011, a divided three-judge panel of the 11th 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 ACA to remain.{{cite news |title=Health Overhaul Is Dealt Setback |url=https://www.wsj.com/articles/SB10001424053111904006104576504383685080762 |work=The Wall Street Journal |first=Brent |last=Kendall |date=August 13, 2011 |access-date=August 19, 2016 |archive-date=October 6, 2016 |archive-url=https://web.archive.org/web/20161006054652/http://www.wsj.com/articles/SB10001424053111904006104576504383685080762 |url-status=live }}

In September 2011, the Department of Justice decided not to ask for an en banc review by the 11th Circuit, and instead asked the U.S. Supreme Court to hear the case.{{cite web | last=Yost | first=Pete | title=Govt. won't seek appeal in Atlanta on health care | website=Worcester Telegram | date=2011-09-27 |url=https://www.telegram.com/story/news/local/north/2011/09/27/govt-won-t-seek-appeal/49888835007/ | access-date=2024-08-10}}{{cite web |first=Stephanie |last=Cutter |url=https://obamawhitehouse.archives.gov/blog/2011/09/28/obama-administration-asks-supreme-court-hear-health-care-lawsuit |title=Obama Administration Asks Supreme Court to Hear Health Care Lawsuit |date=September 28, 2011 |via=National Archives |work=whitehouse.gov |access-date=April 1, 2012 |archive-date=February 8, 2017 |archive-url=https://web.archive.org/web/20170208164226/https://obamawhitehouse.archives.gov/blog/2011/09/28/obama-administration-asks-supreme-court-hear-health-care-lawsuit |url-status=live }} On November 14, 2011, the Supreme Court agreed to hear the case.{{cite news|last=Denniston|first=Lyle|title=Court sets 5 1/2-hour hearing on health care|url=http://www.scotusblog.com/2011/11/court-sets-5-12-hour-hearing-on-health-care/|publisher=SCOTUSblog|date=November 14, 2011|access-date=June 30, 2012|archive-date=June 26, 2012|archive-url=https://web.archive.org/web/20120626224209/http://www.scotusblog.com/2011/11/court-sets-5-12-hour-hearing-on-health-care|url-status=live}}

Almost immediately after the passage of the ACA, the Virginia state legislature passed a law that purported to nullify the individual mandate provision of the federal Act.{{cite magazine |last=Sampson |first=Zinie Chen |title=Va. AG sues over federal health care overhaul |access-date=December 20, 2010 |magazine=Businessweek |url=http://www.businessweek.com/ap/financialnews/D9EKHKK00.htm |archive-url=https://web.archive.org/web/20100327102344/http://www.businessweek.com/ap/financialnews/D9EKHKK00.htm |url-status=dead |archive-date=March 27, 2010 |date=March 23, 2010}} Virginia Attorney General Ken Cuccinelli then sued Secretary of Health and Human Services Kathleen Sebelius in the U.S. District Court for the Eastern District of Virginia. Cuccinelli's lawsuit was separate from the states participating in Florida's lawsuit. The case was heard by Judge Henry E. Hudson, who was appointed to the bench by George W. Bush.

On May 24, 2010, the Obama administration filed a motion to dismiss the lawsuit, arguing that states cannot escape federal law simply by passing state laws that contravene federal ones.{{cite news|last=Lewis|first=Bob|title=Feds Ask Va. Health Reform Lawsuit Be Dismissed|url=https://abcnews.go.com/US/wireStory?id=10733518&page=1|access-date=December 20, 2010|newspaper=Associated Press|date=May 24, 2010}} Cuccinelli filed a counter-motion on June 7, rebutting federal claims and asserting that health insurance was not commerce as intended by the Constitution, and, thus, was not subject to regulation by Congress.{{cite news|last=Helderman|first=Rosalind|title=Virginia attorney general urges judge to let suit over health-care law proceed|url=https://www.washingtonpost.com/wp-dyn/content/article/2010/06/07/AR2010060704258.html|access-date=December 20, 2010|newspaper=The Washington Post|date=June 7, 2010|archive-date=November 11, 2012|archive-url=https://web.archive.org/web/20121111181543/http://www.washingtonpost.com/wp-dyn/content/article/2010/06/07/AR2010060704258.html|url-status=live}}

A hearing was held on July 2, 2010, where similar arguments were put forth by both sides.{{cite news|last=Helderman|first=Rosalind|title=Va. begins courtroom assault on federal health-care overhaul|url=https://www.washingtonpost.com/wp-dyn/content/article/2010/07/01/AR2010070106199.html|access-date=20 December 2010|newspaper=The Washington Post|date=July 2, 2010}} On December 13, 2010, Hudson ruled that the individual mandate portion of the health care bill was unconstitutional. However, Hudson did not block implementation of the law while the case continued working its way through the court system.{{cite news |last=Mears |first=Bill |title=Virginia judge rules health care mandate unconstitutional |url=http://www.cnn.com/2010/POLITICS/12/13/health.care/index.html? |publisher=CNN |access-date=December 13, 2010}}{{cite news |url=https://www.washingtonpost.com/wp-dyn/content/article/2010/12/13/AR2010121302420.html? |title=Federal judge in Va. strikes down part of health-care law |first1=Rosalind S. |last1=Helderman |first2=Amy |last2=Goldstein |newspaper=The Washington Post |date=December 13, 2010 |access-date=December 13, 2010 |archive-date=January 23, 2011 |archive-url=https://web.archive.org/web/20110123031807/http://www.washingtonpost.com/wp-dyn/content/article/2010/12/13/AR2010121302420.html |url-status=live }}

The Obama administration appealed the case to the United States Court of Appeals for the Fourth Circuit, which granted a request from both parties for an expedited process. On February 3, 2011, Cuccinelli announced that he intended to file an appeal directly with the Supreme Court, bypassing the Court of Appeals; this request was denied by the Supreme Court on April 25.{{cite news |url=https://www.wsj.com/articles/SB10001424052748704376104576122593647702576 |title=Health Foes Try Divergent Tactics |access-date=February 6, 2011 |author=Kendall, Brent |date=February 4, 2011 |work=The Wall Street Journal |archive-date=January 18, 2016 |archive-url=https://web.archive.org/web/20160118233302/http://www.wsj.com/articles/SB10001424052748704376104576122593647702576 |url-status=live }} Hearings were held on May 10, 2011, and May 13, 2011, in Richmond.{{cite news|url=http://www.nbc29.com/Global/story.asp?S=13916155|title=Appeals Court Expedites Health Care Lawsuit|date=January 26, 2011|access-date=January 27, 2011|publisher=NBC29|archive-date=January 12, 2012|archive-url=https://web.archive.org/web/20120112211108/http://www.nbc29.com/Global/story.asp?S=13916155|url-status=live}}

On September 8, 2011, the appellate court reversed Hudson's decision, in a decision issued by Judge Diana Gribbon Motz. The Fourth Circuit panel ruled that Virginia lacked subject-matter jurisdiction. The state law that was the basis of Cuccinelli's lawsuit was deemed invalid because Virginia lacks the authority to supersede or override federal law. Simply creating a law to use as a smokescreen for the guise of challenging a federal law did not constitute standing.{{cite news |title=Fourth Circuit of Appeals Decision |url=http://www.liberty.edu/media/9980/attachments/opinion_healthcare_4th_va_v_sebelius_090811.pdf |access-date=September 8, 2011 |author=Diana Gribbon Motz |date=September 8, 2011 |archive-url=https://web.archive.org/web/20120111124212/http://www.liberty.edu/media/9980/attachments/opinion_healthcare_4th_va_v_sebelius_090811.pdf |archive-date=January 11, 2012 |url-status=dead |df=mdy-all }}

On September 30, 2011, Virginia requested that the Supreme Court issue certiorari to hear the case. The petition was denied on June 29, 2012.{{cite web|title=Supreme Court Cases 11-1057, 11-1058|url=https://www.supremecourt.gov/docketfiles/11-420.htm|access-date=July 17, 2012|archive-date=August 10, 2024|archive-url=https://web.archive.org/web/20240810090140/https://www.supremecourt.gov/docketfiles/11-420.htm|url-status=live}}

On November 30, 2010, U.S. District Court Judge Norman K. Moon, who sits in Virginia, also declared the individual mandate constitutional in Liberty University v. Geithner. He also declared the employer mandate constitutional. He rejected two other arguments that government lawyers have made in cases across the country in defending the new law: first, that no one has legal standing to bring challenges at this point to the 2014 mandates, and second that any such challenge is premature. He rejected the challengers' basic argument that Congress had no authority to order someone to give up their own desire not to buy a commercial product and force them into a market they do not want to enter. He said:{{Blockquote|Regardless of whether one relies on an insurance policy, one's savings, or the backstop of free or reduced-cost emergency room services, one has made a choice regarding the method of payment for the health care services one expects to receive. Far from "inactivity", by choosing to forgo insurance, [individuals] are making an economic decision to try to pay for health care services later, out of pocket, rather than now, through the purchase of insurance ... As Congress found, the total incidence of these economic decisions has a substantial impact on the national market for health care by collectively shifting billions of dollars on to other market participants and driving up the prices of insurance policies.Denniston, Lyle (December 1, 2010). [http://www.scotusblog.com/2010/12/second-ruling-upholds-health-clause/ "Second ruling upholds health clause"] {{Webarchive|url=https://web.archive.org/web/20120914160704/http://www.scotusblog.com/2010/12/second-ruling-upholds-health-clause/ |date=September 14, 2012 }}. SCOTUSblog.}}

On February 22, 2011, Judge Gladys Kessler of the U.S. District Court for the District of Columbia, rejected a challenge to the law in Mead v. Holder by five individuals who argued, among other things, that the Patient Protection and Affordable Care Act violated the Religious Freedom Restoration Act, and that the individual mandate exceeded Congress's power under the Interstate Commerce Clause. Kessler rejected as "pure semantics" plaintiffs' argument that failing to acquire insurance was the regulation of inactivity, noting that "those who choose not to purchase health insurance will ultimately get a 'free ride' on the backs of those Americans who have made responsible choices to provide for the illness we all must face at some point in our lives." Kessler ruled that individual mandate was a valid exercise of Congress's power to regulate interstate commerce.{{cite web|url=https://www.justice.gov/healthcare/|title=Defending the Affordable Care Act|publisher=United States Department of Justice|access-date=February 24, 2011|archive-url=https://web.archive.org/web/20140412161247/http://www.justice.gov/healthcare/|archive-date=April 12, 2014|url-status=dead|df=mdy-all}}{{Cite news|url=http://blogs.abcnews.com/thenote/2011/02/third-federal-judge-upholds-health-care-law-score-now-3-2.html|title=Third Federal Judge Upholds Health Care Law; Score Now 3–2|work=ABC News|access-date=February 24, 2011|archive-date=February 24, 2011|archive-url=https://web.archive.org/web/20110224131929/http://blogs.abcnews.com/thenote/2011/02/third-federal-judge-upholds-health-care-law-score-now-3-2.html|url-status=live}}

On October 8, 2010, U.S. District Court Judge George Caram Steeh in Thomas More Law Center v. Obama wrote that in his view the ACA, including the individual mandate, was constitutional.Denniston, Lyle (October 7, 2010). [http://www.scotusblog.com/2010/10/health-insurance-mandate-upheld/ "Health insurance mandate upheld"] {{Webarchive|url=https://web.archive.org/web/20120620155744/http://www.scotusblog.com/2010/10/health-insurance-mandate-upheld |date=June 20, 2012 }}. SCOTUSblog. He rejected a private suit{{cite web |title=Thomas More Law Center et al v. Barack Obama et al |date=March 20, 2010 |publisher=U.S. District Court for the Eastern District of Michigan |url=http://www.thomasmore.org/downloads/sb_thomasmore/TMLCFilesCourtChallengeMomentsAfterObamaHealt.pdf |access-date=2010-10-14 |archive-url=https://web.archive.org/web/20120216160941/http://www.thomasmore.org/downloads/sb_thomasmore/TMLCFilesCourtChallengeMomentsAfterObamaHealt.pdf |archive-date=February 16, 2012 |url-status=dead }} filed by Michigan's Thomas More Law Center and several state residents that focused on the Commerce Clause, deciding that Congress had the power to pass the law because it affected interstate commerce and was part of a broader regulatory scheme.{{cite news |url=https://www.cbsnews.com/news/michigan-judge-upholds-provisions-in-health-care-law/ |title=Michigan Judge Upholds Provisions in Health Care Law |work=CBS News |date=October 7, 2010 |access-date=October 13, 2010 |first=Jan |last=Crawford}}{{cite news |url=https://www.nytimes.com/2010/10/08/health/policy/08health.html |last=Sack |first=Kevin |title=Judge Rules Health Law Is Constitutional |work=The New York Times |date=October 7, 2010 |access-date=October 13, 2010 |archive-date=September 3, 2011 |archive-url=https://web.archive.org/web/20110903030539/http://www.nytimes.com/2010/10/08/health/policy/08health.html |url-status=live }}

On June 29, 2011, a divided three-judge panel of the Sixth Circuit Court of Appeals affirmed the decision.Thomas More Law Ctr. v. Obama, 2011 U.S. App. LEXIS 13265, 2011 WL 2556039 (6th Cir. Mich. 2011) Judge Jeffrey Sutton, a member of the three judge panel appointed by George W. Bush, was the first Republican-appointed judge to rule that the law is constitutional.{{cite news |url=https://www.latimes.com/health/la-xpm-2011-jun-30-sc-dc-0630-healthcare-ruling-20110630-story.html |work=Los Angeles Times |first1=Noam |last1=Levey |first2=David |last2=Savage |title=Appeals court declares health law constitutional |date=June 30, 2011 |access-date=June 30, 2012 |archive-date=June 19, 2012 |archive-url=https://web.archive.org/web/20120619002620/http://articles.latimes.com/2011/jun/30/news/sc-dc-0630-healthcare-ruling-20110630 |url-status=live }}

In Seven-Sky v. Holder on November 8, 2011, the U.S. Court of Appeals for the District of Columbia upheld the constitutionality of the law.{{cite news |url=https://www.forbes.com/sites/rickungar/2011/11/08/d-c-court-of-appeals-upholds-constitutionality-of-obamacare-stuns-conservatives/ |title=D.C. Court of Appeals Upholds Constitutionality of Obamacare, Stuns Conservatives |work=Forbes |first=Rick |last=Ungar |date=November 8, 2011 |access-date=August 26, 2017 |archive-date=September 17, 2016 |archive-url=https://web.archive.org/web/20160917233113/http://www.forbes.com/sites/rickungar/2011/11/08/d-c-court-of-appeals-upholds-constitutionality-of-obamacare-stuns-conservatives/ |url-status=live }}{{cite news |last=Pickler |first=Nedra |url=https://news.yahoo.com/appeals-court-upholds-obama-health-care-law-161931692.html |title=Appeals court upholds Obama health care law |agency=Associated Press |publisher=Yahoo! News |date=November 8, 2011 |access-date=April 1, 2012 |archive-date=May 27, 2012 |archive-url=https://web.archive.org/web/20120527213048/http://news.yahoo.com/appeals-court-upholds-obama-health-care-law-161931692.html |url-status=live }} The decision was written by Senior Judge Laurence Silberman, a prominent conservative judge, and joined by Senior Judge Harry T. Edwards, who also filed a concurring opinion. Judge Brett Kavanaugh dissented, stating that the Tax Anti-Injunction Act precluded the court from hearing the case until after the individual mandate took effect. It was reported that the Supreme Court might attempt to follow Kavanaugh's opinion had they wished to hold off on deciding the issue. The Supreme Court indeed heard oral arguments regarding the Tax Anti-Injunction Act, ultimately unanimously ruling (though with differing rationales) that it did not apply to this case.

{{Main article|National Federation of Independent Business v. Sebelius|}}

On November 14, 2011, the Supreme Court of the United States issued a writ of certiorari to the United States Appeals Court for the Eleventh Circuit to consider appeals to its rulings in National Federation of Independent Business v. Sebelius and Florida v. United States Department of Health and Human Services. The Court heard oral arguments March 26–28, 2012 and decided the consolidated case on June 28, 2012.

Although the Supreme Court declared that the law could not have been upheld under an argument based on the regulatory power of Congress under the Commerce Clause, the Court declared that the legislatively-declared "penalty" was constitutional as a valid exercise of the Congressional power to tax, thus upholding the individual mandate. The Court also limited the expansion of Medicaid initially proposed under the ACA. All provisions of the ACA continue to be in effect, with some limits on the Medicaid expansion.{{cite web |title=Analysis: U.S. Supreme Court Upholds the Affordable Care Act: Roberts Rules? |url=http://www.natlawreview.com/article/analysis-us-supreme-court-upholds-affordable-care-act-roberts-rules |publisher=von Briesen & Roper, S.C. |work=The National Law Review |date=June 29, 2012 |access-date=July 2, 2012 |archive-date=July 2, 2012 |archive-url=https://web.archive.org/web/20120702224304/http://www.natlawreview.com/article/analysis-us-supreme-court-upholds-affordable-care-act-roberts-rules |url-status=live }}

As of August 2013, scores of lawsuits were still targeting parts of the ACA.{{cite magazine |url=http://mobile.businessweek.com/articles/2013-08-01/obamacare-may-be-headed-back-to-the-supreme-court |title=Obamacare May Be Headed Back to the Supreme Court |magazine=Bloomberg Businessweek |date=August 1, 2013 |first=Greg |last=Stohr |access-date=August 13, 2013 |archive-url=https://web.archive.org/web/20131202231352/http://mobile.businessweek.com/articles/2013-08-01/obamacare-may-be-headed-back-to-the-supreme-court |archive-date=December 2, 2013 |url-status=dead }}

The Pacific Legal Foundation initiated a lawsuit, Sissel v. U.S. Dept. Health & Human Services, in the U.S. District Court for the District of Columbia arguing that the ACA was still unconstitutional, even in light of the "saving construction" given the law in NFIB v. Sebelius, on the ground that the enactment of the essential coverage mandate violated the Origination Clause.{{cite web |url=http://blog.pacificlegal.org/2012/plf-takes-the-next-step-in-challenging-obamacare/ |title=PLF takes the next step in challenging Obamacare |publisher=Pacific Legal Foundation |date=September 12, 2012 |work=Pacific Liberty Blog |access-date=October 1, 2012 |archive-url=https://web.archive.org/web/20120930100240/http://blog.pacificlegal.org/2012/plf-takes-the-next-step-in-challenging-obamacare/ |archive-date=September 30, 2012 |url-status=dead }}{{cite web |url=http://cfif.org/v/index.php/commentary/42/1582-if-obamacare-is-a-tax-did-it-violate-the-origination-clause- |title=If ObamaCare Is a Tax, Did It Violate the Origination Clause? |last=Ellis |first=Ashton |publisher=Center for Individual Freedom |date=September 20, 2012 |access-date=February 9, 2013 |archive-date=February 6, 2013 |archive-url=https://web.archive.org/web/20130206224040/http://cfif.org/v/index.php/commentary/42/1582-if-obamacare-is-a-tax-did-it-violate-the-origination-clause- |url-status=live }} The suit also sought clarification from the District Court as to what extent lower courts were legally bound by the conclusion of Chief Justice Roberts and the four dissenting justices that the Act did not pass constitutional scrutiny by way of the Commerce and Necessary & Proper Clauses. On June 28, 2013, the District Court dismissed the plaintiff's suit, holding (1) that the Commerce Clause challenge to the ACA was foreclosed by the Supreme Court decision in NFIB v. Sebelius, (2) that the Origination Clause challenge failed, as the bill enacting the individual mandate was not a bill for raising revenue, and (3) that even if the bill enacting the individual mandate were a bill for raising revenue, the Origination Clause challenge failed because the bill was an amendment to a bill that had originated in the House of Representatives.Memorandum Opinion, June 28, 2013, Matthew Sissel v. United States Dep't of Health and Human Services, case no. 10-1263 (BAH), U.S. District Court for the District of Columbia. On July 29, 2014, that decision was affirmed by the United States Court of Appeals for the District of Columbia Circuit.Andrew Zajac, "Obamacare Challenge Over Origins of Law Tossed by U.S.," July 29, 2014, Bloomberg News, at [https://www.bloomberg.com/news/2014-07-29/obamacare-challenge-over-origins-of-law-tossed-by-u-s-.html] {{Webarchive|url=https://web.archive.org/web/20140802184518/http://www.bloomberg.com/news/2014-07-29/obamacare-challenge-over-origins-of-law-tossed-by-u-s-.html |date=August 2, 2014 }}.Case no. 13-5202, U.S. Court of Appeals for the District of Columbia Circuit. However, the Court of Appeals concluded that section 5000A of the Internal Revenue Code (sometimes called the "individual mandate") was not a "Bill for raising Revenue", and thus was not subject to the restriction in the Origination Clause of the Constitution. The Court of Appeals stated that, therefore, there was no reason for the Court to determine whether the bill originated in the House of Representatives.See p. 11, slip op., July 29, 2014, Matt Sissel v. United States Department of Health and Human Services, case no. 13-5202, U.S. Court of Appeals for the District of Columbia Circuit. The Court also rejected Sissel's contention that the law violated the Commerce Clause of the Constitution, stating that the U.S. Supreme Court's decision in 2012 in the case of National Federation of Independent Business v. Sebelius "necessarily disposes of Sissel's Commerce Clause claim."See p. 10, slip op., July 29, 2014, Matt Sissel v. United States Department of Health and Human Services, case no. 13-5202, U.S. Court of Appeals for the District of Columbia Circuit.

The Goldwater Institute challenged the ACA in Coons v. Geithner by targeting the Independent Payment Advisory Board.{{cite web |url=http://aznow.biz/health-care/goldwater-institute-moves-challenge-healthcare-law |title=Goldwater Institute Moves Forward With Challenge To Healthcare Law |publisher=AZ Big Media |date=June 28, 2012 |work=AZ Business Magazine |access-date=October 2, 2012 |archive-url=https://web.archive.org/web/20120703212051/http://aznow.biz/health-care/goldwater-institute-moves-challenge-healthcare-law |archive-date=July 3, 2012 |url-status=dead }} According to the Goldwater Institute, the board "will be able to dictate how much doctors can charge for medical care, how insurance companies will pay for it, and when patients can get access to cutting-edge treatments."{{cite web |url=http://www.goldwaterinstitute.org/article/coons-v-geithner-federal-health-care-lawsuit |title=Coons v. Geithner (federal health care lawsuit) |publisher=Goldwater Institute |access-date=September 8, 2010 |archive-date=March 6, 2012 |archive-url=https://web.archive.org/web/20120306200541/http://www.goldwaterinstitute.org/article/coons-v-geithner-federal-health-care-lawsuit |url-status=live }} The litigants argued that because these decisions could not be reviewed by Congress or the courts, the health care legislation violated the separation of powers doctrine. The last claims in the lawsuit were dismissed on December 19, 2012.[http://www.leagle.com/decision?q=In+FDCO+20121220E81.xml Coons v. Geithner] {{Webarchive|url=https://web.archive.org/web/20240810090143/https://www.leagle.com/decision/infdco20121220e81.xml |date=August 10, 2024 }} (December 19, 2012) United States District Court, D. Arizona. No. CV-10-1714-PHX-GMS.

In August 2013, a U.S. District Court denied the federal government's motion for complete dismissal of a state of Oklahoma lawsuit, Pruitt v. Sebelius, challenging some tax aspects of the ACA, and allowed the lawsuit to proceed. Republican Oklahoma Attorney General Scott Pruitt said: "Oklahoma challenged implementation of the Affordable Care Act after the IRS finalized a rule that would allow the federal government to punish 'large employers' including local government with millions of dollars of tax penalties in states without health care exchanges, which is not allowed under the health care law."{{cite news |last=Harris |first=Andrew |title=Oklahoma's Challenge to Obama Health-Care Law to Proceed |url=https://www.bloomberg.com/news/2013-08-13/oklahoma-s-challenge-to-obama-health-care-law-to-proceed.html |access-date=August 20, 2013 |newspaper=Bloomberg News |date=August 12, 2013 |archive-date=August 16, 2013 |archive-url=https://web.archive.org/web/20130816093903/http://www.bloomberg.com/news/2013-08-13/oklahoma-s-challenge-to-obama-health-care-law-to-proceed.html? |url-status=live }}

AG Pruitt contends that the law as passed allowed these federal penalties to be assessed in states with state insurance exchanges, but did not allow for the same fines to be assessed in states which chose not to set up a state exchange, and thus would be operating under the federal insurance exchanges.{{cite news |last=Harris |first=Andrew |title=Oklahoma's challenge to Obama health-care law to proceed |url=https://www.bloomberg.com/news/2013-08-13/oklahoma-s-challenge-to-obama-health-care-law-to-proceed.html |access-date=August 20, 2013 |newspaper=Bloomberg News |date=August 12, 2013 |archive-date=August 16, 2013 |archive-url=https://web.archive.org/web/20130816093903/http://www.bloomberg.com/news/2013-08-13/oklahoma-s-challenge-to-obama-health-care-law-to-proceed.html? |url-status=live }}

A lawsuit entitled United States House of Representatives v. Price (previously Burwell) was filed in late 2014 concerning the cost-sharing program and implementation of the law. The case was eventually settled before the Court of Appeals in D.C.{{Cite journal|url=https://www.healthaffairs.org/do/10.1377/forefront.20171215.665944/full/|title=Settlement In Cost-Sharing Reduction Payment Case|year=2017|doi=10.1377/forefront.20171215.665944|journal=Health Affairs Forefront|access-date=March 29, 2022|archive-date=August 10, 2024|archive-url=https://web.archive.org/web/20240810090142/https://www.healthaffairs.org/content/forefront/aca-round-up-court-blocks-new-contraceptive-coverage-rules-csr-case-settlement-final|url-status=live}}

In February 2018, 20 states, led by Texas Attorney General Ken Paxton and Wisconsin Attorney General Brad Schimel, filed a lawsuit against the federal government alleging the ACA is now unconstitutional because the individual mandate tax which NFIB v. Sebelius rested on was repealed by the Tax Cuts and Jobs Act of 2017.[https://thehill.com/policy/healthcare/375760-20-states-file-lawsuit-alleging-obamacare-is-unconstitutional/ 20 states file lawsuit alleging ObamaCare is unconstitutional] {{Webarchive|url=https://web.archive.org/web/20230826040559/https://thehill.com/policy/healthcare/375760-20-states-file-lawsuit-alleging-obamacare-is-unconstitutional/ |date=August 26, 2023 }} (The Hill) In December 2018, he declared the entire law to be unconstitutional.{{cite web |url=https://thehill.com/policy/healthcare/421511-federal-judge-in-texas-strikes-down-obamacare/ |title=Federal judge in Texas strikes down ObamaCare |website=The Hill |access-date=15 December 2018 |archive-date=December 15, 2018 |archive-url=https://web.archive.org/web/20181215013835/https://thehill.com/policy/healthcare/421511-federal-judge-in-texas-strikes-down-obamacare |url-status=live }}

{{main|California v. Texas}}

In March 2018, in a suit brought by Texas and other states, Judge Reed O'Connor of the Northern District of Texas ruled against the imposition of a federal tax on states as a condition of continuing to receive Medicaid funds, ruling that while the tax was lawful, the regulation implementing it violated the nondelegation doctrine and the Administrative Procedure Act.{{Cite web|url=http://premiumtaxcredits.wikispaces.com/file/view/177111375176.pdf|title=Texas, et al. v. U.S.|archive-url=https://archive.today/20180416023747/http://premiumtaxcredits.wikispaces.com/file/view/177111375176.pdf|archive-date=2018-04-16}}{{Cite journal|url=https://www.healthaffairs.org/do/10.1377/forefront.20180313.321472/full/|title=Court Strikes Parts Of Medicaid Managed Care Regulation Over Health Insurance Tax|year=2018|doi=10.1377/forefront.20180313.321472|journal=Health Affairs Forefront|access-date=March 29, 2022|archive-date=August 10, 2024|archive-url=https://web.archive.org/web/20240810090145/https://www.healthaffairs.org/content/forefront/aca-round-up-steep-premium-hikes-projected-parts-medicaid-managed-care-rule-invalidated|url-status=live}} As the Trump administration refused to appeal the decision, a coalition of states led by California led the appeal to this ruling to the Fifth Circuit, which upheld it in parts. Both parties sought review by the Supreme Court, which ruled on June 17, 2021 in California v. Texas that Texas and the other plaintiff states did not have standing to challenge the individual mandate provision to begin with.{{Cite web|url=https://apnews.com/article/supreme-court-dismisses-obamacare-challenge-67cc2e9604a70b1b329c5f3b4177a688|title=Supreme Court dismisses challenge to Obama health law|first=Mark|last=Sherman|date=June 17, 2021|accessdate=June 17, 2021|publisher=Associated Press|archive-date=October 15, 2021|archive-url=https://web.archive.org/web/20211015225822/https://apnews.com/article/supreme-court-dismisses-obamacare-challenge-67cc2e9604a70b1b329c5f3b4177a688|url-status=live}}{{cite web |url=https://www.msnbc.com/rachel-maddow-show/affordable-care-act-survives-supreme-court-challenge-again-n1271151 | title = Affordable Care Act survives Supreme Court challenge (again) | first = Steve | last = Benen | author-link = Steve Benen | date = June 17, 2021 | accessdate = June 17, 2021 | work = MSNBC | archive-date = November 6, 2021 | archive-url=https://web.archive.org/web/20211106212447/https://www.msnbc.com/rachel-maddow-show/affordable-care-act-survives-supreme-court-challenge-again-n1271151 | url-status = live }}

In September 2022, the same district court judge, Reed O'Connor, ruled that the legal requirements to cover HIV-prevention drugs, as prescribed by section 1001(5) of the Affordable Care Act, violate the Constitution of the United States.Braidwood Management, Inc. v. Xavier Becerra, No. 4:20-cv-00283-O, [https://www.courthousenews.com/wp-content/uploads/2022/09/braidwood-becerra-ruling-usdc-texas.pdf] {{Webarchive|url=https://web.archive.org/web/20221116151744/https://www.courthousenews.com/wp-content/uploads/2022/09/braidwood-becerra-ruling-usdc-texas.pdf |date=November 16, 2022 }} (N.D. Tex.) September 7, 2022{{cite web |url=https://www.click2houston.com/news/texas/2022/09/07/religious-employers-need-not-cover-prep-in-their-health-plans-federal-judge-rules/ |title=Religious employers need not cover PrEP in their health plans, federal judge rules |first1=Eleanor |last1=Klibanoff |first2=Karen Brooks |last2=Harper |date=September 7, 2022 |website=Click 2 Houston |access-date=2022-09-08 |language=en-US |archive-date=September 8, 2022 |archive-url=https://web.archive.org/web/20220908122036/https://www.click2houston.com/news/texas/2022/09/07/religious-employers-need-not-cover-prep-in-their-health-plans-federal-judge-rules/ |url-status=live }}{{cite web |url=https://www.vox.com/policy-and-politics/2022/9/7/23341076/obamacare-reed-oconnor-prep-supreme-court-braidwood-becerra-affordable-care-act |title=Obamacare is under attack by Republican judges again. Here's what's at stake. |first=Ian |last=Millhiser |date=September 7, 2022 |website=Vox |access-date=2022-09-08 |language=en-US |archive-date=November 16, 2022 |archive-url=https://web.archive.org/web/20221116152832/https://www.vox.com/policy-and-politics/2022/9/7/23341076/obamacare-reed-oconnor-prep-supreme-court-braidwood-becerra-affordable-care-act |url-status=live }} The ruling was upheld by the Fifth Circuit in June 2024, which ruled that because members of the United States Preventive Services Task Force body are not confirmed by the Senate, their requirements were unconstitutional.{{cite web | url = https://apnews.com/article/preventative-health-care-obama-appeals-court-cf339b95c1d285e7844225b8021d7e54 | title = Federal appeals court says some employers can exclude HIV prep from insurance coverage | first = Kevin | last = McGill | date = June 21, 2024 | accessdate = January 11, 2025 | agency = Associated Press }} The Supreme Court certified the government's petition in January 2025, to be heard under Becerra v. Braidwood Management in 2025.{{cite web | url = https://www.nbcnews.com/politics/supreme-court/supreme-court-obamacare-requirements-health-care-rcna187282 | title = Supreme Court to weigh reinstating Obamacare care requirements struck down by lower court | date = January 10, 2025 | accessdate = January 11, 2025 | agency = Associated Press | via = NBC News }}

• King v. Burwell
• Zubik v. Burwell
• United States House of Representatives v. Price
• Efforts to repeal the Patient Protection and Affordable Care Act

{{reflist|30em}}

Category:Affordable Care Act

Category:United States case law lists