As employers and their third-party administrators begin to wrap-up their Patient Protection and Affordable Care Act (“ACA”) reporting for the 2018 tax year, we’ve started to receive questions about what comes next.  As we discussed here, with the implementation of the Tax Cuts and Jobs Act of 2017 (the “Act”), the ACA’s “individual mandate”

On December 14, 2018, a federal district judge sitting in Texas ruled that, without the so-called “individual mandate” which requires individual taxpayers to maintain minimum essential coverage, the rest of the Patient Protection and Affordable Care Act as amended (widely known as the “ACA”) is “INVALID”.

What was the case about?

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The individual mandate provision of the 2010 health care reform law is unconstitutional, the U.S. Court of Appeals for the Eleventh Circuit decided in Florida v. HHS on August 12th. The Sixth Circuit previously held in Thomas More Law Center v. Obama that the individual mandate is constitutional. Therefore, the Eleventh Circuit decision creates a

Federal District Court Judge, Roger Vinson, for the Northern District of Florida, Pensacola Division struck down the Patient Protection and Affordable Care Act (“PPACA”), the Federal health reform law dubbed by its critics as “Obamacare,” on Constitutional grounds yesterday. Judge Vinson agreed with the Attorneys General of 26 states that the mandates of the law exceeded the authority granted to the Federal government under the Commerce Clause to the U.S. Constitution. See Bondi v. U.S. Dept. of Health and Human Services, (N.D. Fla. 1/31/2011). The decision follows three prior Federal District Court decisions, two upholding the law and one striking it down for similar reasons.

The essence of the decision is that the law’s “individual mandate” – which requires all Americans to purchase a minimum level of health insurance beginning in 2014 or incur a penalty, goes beyond the Federal government’s power to regulate interstate commence rooted in what is known as the “Commerce Clause” of the Constitution. The District Court also held, citing the Justice Department’s own arguments concerning the critical function the individual mandate serves with respect to the PPACA as a whole, that the law “cannot survive without the individual mandate” and must therefore fail along with the individual mandate. In so ruling, Judge Vinson wrote:

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 unanimous 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.

The Bondi decision, although it represents a significant victory for opponents of the health reform law, was not a total victory on all points for the Attorneys General and others who filed the lawsuit. Significantly, the District Court declined to order the Federal government to cease its activities in implementing the PPACA. It also rejected the plaintiff’s argument that the PPACA’s provisions requiring States to pay for a portion of the expansion of Medicaid beginning in 2014 improperly interfered with State sovereignty.

As a result of these limitations, Bondi will have little immediate practical effect on the implementation of the health reform law. The U.S. Justice Department immediately announced that it would appeal the District Court’s decision to the Eleventh Circuit.

It is unclear how the Eleventh Circuit or the Supreme Court will resolve these legal issues should the case proceed as most expect it will, or what changes might be made to the law in the coming days and weeks as Republicans buoyed by the decision are marshaling their forces in Congress to advance legislation to “repeal and replace.” We’ll all be staying tuned.

The following are some excerpts from the decision which provide a view into the reasoning of the Court . . .


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