Early this afternoon the 11th Circuit Court of Appeals declared the individual mandate of the PPACA unconstitutional in a 2-1 decision.
The case, Florida v. U.S. Department of Health and Human Services, is the matter filed on behalf of 26 states, the NFIB, and a handful of individual plaintiffs. Most notably the lower court decision in this case was one of only two declaring the individual mandate unconstitutional, and the only case declaring the entirety of Obamacare unconstitutional as a result.
My previous analysis from January 2011 of the lower court ruling can be found here.
What this means for the Supreme Court
The Supreme Court now has two competing appellate decisions from different parts of the country on the same issue: the earlier decision from the 6th Circuit upholding the individual mandate, and now this decision from the 11th Circuit declaring the individual mandate unconstitutional. This "circuit split" is one of the strong factors considered by the Supreme Court when deciding to take a case.
What this means for the challengers in the 11th Circuit
There was always a danger that the 11th Circuit challengers might win this case, but that the government might seek and obtain en banc review (review by the entire appellate court). This would have delayed a petition to the Supreme Court for months and months. Instead the challengers lost on a couple of issues, and may file a petition for Writ of Certiorari as soon as they are ready.
Introduction to the opinion
The opinion is a monstrous 304 pages (including the brief appendix). Below is an analysis primarily of the majority decision, and what it means for challengers of the individual mandate throughout the country. Judges Dubina and Hull wrote for the majority, while Judge Marcus wrote the dissent.
Findings and Medicaid - the first 67 pages
Most of the first 67 pages are devoted to stating factual findings, primarily reciting the legislative history of the PPACA, Congressional findings regarding the bill, and actual terms of the bill.
Did you know the suit filed by the states challenged Congressional authority to expand the mandates within Medicaid? This is the portion of the lawsuit in which Virginia did not also file a similar action. The states actually lost on this issue in the lower court and the decision was the same here before the 11th Circuit. The short version of how Medicaid works is that states may opt out of the program, and so any constraint placed on the program by Congress are inherently not coercive, and coercion equals unconstitutionality.
The history of the Commerce Clause and explanation of the necessary and proper clause
The Commerce Clause is one of the enumerated powers under Article 1 § 8 of the U.S. Constitution allowing Congress to write laws "To regulate Commerce with foreign Nations, and among the several States . . ." The majority goes to great lengths to detail commerce clause jurisprudence in pages 67-92 of the opinion. A Constitutional law course on the Commerce Clause could be taught from this portion of the brief.
Pages 92-99 are devoted to explaining the Necessary and Proper Clause also of Article 1 § 8 of the U.S. Constitution allowing Congress "to make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers, and all other Powers vested by this Constitution in the Government of the United States . . ."
The individual mandate exceeds the powers allowed under the Commerce Clause
Given the length of the opinion I will allow the judges to speak for themselves:
In commenting on the court's need to intervene: "When Congress oversteps those outer limits [of the Commerce Clause], the Constitution requires judicial engagement, not judicial abdication." p. 104.
On the issue of activity v. inactivity: "[T]he Supreme Court has always described the commerce power as operating on already existing or ongoing activity." p. 108. Nonetheless, "we are not persuaded that the formalistic dichotomy of activity and inactivity provides a workable or persuasive enough answer in this case." p. 109. The decision is not made based on the concept that not buying health insurance constitutes activity or inactivity.
What the Court views as the actual legal question: "We perceive the question before us to be whether the federal government can issue a mandate that Americans purchase and maintain health insurance from a private company for the entirety of their lives." p. 112.
On the unprecedented nature of behavioral mandates (economic or otherwise): "Given the attractiveness of the power to compel behavior in order to solve important problems, we find it illuminating that Americans have, historically, been subject only to a limited set of personal mandates: serving on juries, registering for the draft, filing tax returns, and responding to the census." p. 119. "[T]he individual mandate is a sharp departure from all prior exercises of federal power." p. 120.
Why looking at the decision to not purchase health insurance by everyone (i.e. in the aggregate) is not a justification for the individual mandate: "Applying aggregation principles to an individual’s decision not to purchase a product would expand the substantial effects doctrine to one of unlimited scope." p. 124. "Although any decision not to purchase a good or service entails commercial consequences, this does not warrant the facile conclusion that Congress may therefore regulate these decisions pursuant to the Commerce Clause." p. 125.
On what is actually being regulated: "But the individual mandate does not regulate behavior at the point of consumption . . . Instead, the language of the individual mandate in fact regulates a related, but different, subject matter: when health insurance is purchased." p. 130 (internal quotations omitted).
Why the federal government's analysis of Commerce Clause Jurisdiction is incorrect
On the nefarious reason why the federal government chooses to argue that the individual mandate is Constitutional under the Commerce Clause because it regulates the consumption of healthcare (as opposed to health insurance): "Because an individual’s decision to forego purchasing a product is so incongruent with the “activities” previously reached by Congress’s commerce power, the government attempts to limit the individual mandate’s far-reaching implications. Accordingly, the government adroitly and narrowly redefines the regulated activity as the uninsured’s health care consumption and attendant cost-shifting, or the timing and method of payment for such consumption." pp. 135-136.
On the issue of the uniqueness of the healthcare system as the government's argument for allowing this one infringement of the bounds of the Commerce Clause: "The government’s five factual elements of “uniqueness,” proposed as constitutional limiting principles, are nowhere to be found in Supreme Court precedent. Rather, they are ad hoc, devoid of constitutional substance, incapable of judicial administration—and, consequently, illusory." p. 168. Translated this means the government's argument that healthcare is a special area of the economy and has different Constitutional limitations has absolutely no basis in law.
The other concerns of the Court and the thrilling conclusion
The Court acknowledged that insurance is traditionally an area of state concern and this increases the Constitutional concerns. The Court also indicates that striking the individual mandate will not hinder the ability of Congress to regulate insurance companies.
And most importantly the sweeping conclusion! "The federal government’s assertion of power, under the Commerce Clause, to issue an economic mandate for Americans to purchase insurance from a private company for the entire duration of their lives is unprecedented, lacks cognizable limits, and imperils our federalist structure." p. 171.
The individual mandate is not a tax
If the penalty from the individual mandate is a tax it is much easier for the government to show that it is Constitutional. The Court noted that no Court has upheld the individual mandate penalty because it is considered a tax. "It is not surprising to us that all of the federal courts, which have otherwise reached sharply divergent conclusions on the constitutionality of the individual mandate, have spoken on this issue with clarion uniformity." p. 173. And later the Court concludes, "The plain language of the statute and well-settled principles of statutory construction overwhelmingly establish that the individual mandate is not a tax, but rather a penalty." p. 174.
And the challengers suffer a major loss
The individual mandate was found to be severable from the remainder of Obamacare. Essentially courts are required to leave a statute intact, and simply remove the unconstitutional portions if at all possible. The lower court found that the individual mandate was not severable from the remainder of the Act and therefore struck down the whole of Obamacare. The 11th Circuit has reversed that decision, and merely determined the individual mandate itself was unconstitutional.
Judge Marcus's dissent
Judge Marcus wrote an over 80 page dissent determining that the individual mandate is Constitutional under the Commerce Clause. I may go back later and pull quotes from this section to show differences in thought form other judges that upheld the individual mandate.
This was a great day for challengers of the individual mandate. A victory was obtained in a federal appellate court accompanied by sound reasoning. This nearly assures that the Constitutionality of the individual mandate will be decided by the Supreme Court.
I may, over the next week, explain the standing ruling in the 11th Circuit and why it does not bode well for the Commonwealth of Virginia.
My previous analysis of litigation regarding the individual mandate can be found here.