Vinson toasts anti-ACA supporters with tea Alas, the Judge Roger Vinson (Florida v. HHS) ruling is here. The Florida-led case remains the media darling of the handful of cases challenging health reform that are rolling through the Federal courts in various circuits across the country. The Florida-led plaintiff list (those opposing the law) brags of 26 states; this case represents a larger Republican strategy to challenge the almost year old health reform law. The plaintiffs argue that the individual mandate (or the provision that all individuals hold health insurance by 2014 and also termed the minimum coverage provision) infringes upon individual liberty. No one should make you buy health insurance – alternatively, the Department of Justice (DOJ) argues that no one should make you pay for those who decide not to buy health insurance. Confused? We are just getting started.

Sit back and let your tea brew… Many have waited anxiously for this moment even though there was little doubt regarding the outcome. Judge Vinson did, however, jolt the media with his far right leaning, tea bag dipping, and Constitution defending language: “it is not hyperbolizing to suggest that Congress could do almost anything it wanted. It is difficult to imagine that a nation which began, at least in part, as the result of opposition to a British mandate giving the East India Company a monopoly and imposing a nominal tax on all tea sold in America would have set out to create a government with the power to force people to buy tea in the first place.”

Vinson’s stance is most striking because of his position on what is termed ‘severability’; in other words, can the ACA stand without the individual mandate? Vinson maintains that while he did not read the entire Affordable Care Act (ACA) (no fair, we did), that it is clear to him that the individual mandate is inextricably linked to the provisions of the ACA and was the intent of Congress. Therefore, the entire law must be declared unconstitutional because it cannot exist without the individual mandate (and the individual mandate is unconstitutional).

Good news? On that front, there remain questions about implementation and the responsibilities of states. Did the Judge grant an injunction? (No.) Do states need to implement the law? (Yes.) Will DOJ appeal to the 11th circuit? (Yes.) Various legal minds are trying to sort through these questions – however, the current analyses suggest that because Vinson issued a declaratory judgment, there is no need for a ‘stay’ – or a requirement that until the appeals process is complete, the law stays put on the books. That is not to say that states won’t think this their ‘out’ – advocates must continue to educate the public about the benefits of the law and move forward with implementation. Jonathan Cohn does his best to summarize this confusing outcome here.

In short, states are not off the hook. The ACA is still the law of the land and unless SCOTUS rules otherwise, our work continues. It is important to remember that as the public reaps the benefits of the law, they will embrace it. This will give SCOTUS pause; overturning ACA will be damaging to all Americans. It is our job to remind the public of a state’s need to continue to work to insure millions of Americans, giving them greater access to health care and better health.

Few commentators are touting the win for Medicaid as a result of this ruling. Judge Vinson did tell the right wing to back off of Medicaid – he maintains that there is no legal foundation to their argument that states are being coerced into the program. This is encouraging news for advocates who are working tirelessly to protect a vital program for vulnerable populations.

Keep the context. The ruling differs from that of Judge Henry Hudson (Virginia v. Sebelius) issued this past December.  Hudson did not go as far as Vinson in his ruling – although Hudson claims that the individual mandate is unconstitutional, he does not maintain that the entire law is null and void. It is important to put all of this into context. These are two rulings of four – the two opposed to the ACA are both from Republican appointed judges in more right leaning circuits (yes, this is part of a Republican strategy as to where they filed cases) while the two rulings in support of the ACA come from Democratic appointed judges – and judges have thrown out 12 cases due to a lack of merit. So, the rulings scoreboard reads 2-2 and we are not even to the seventh inning stretch.

Therefore, the most important ‘take away’ from Vinson is that this is one piece of a larger judicial process – more rulings will be unveiled before the Supreme Court makes its determination regarding the constitutionality of the ACA. However, as pointed out by our own Michael Miller, the ruling is fodder for Republicans to feed their far right base and motivate newly reddened states to hold defiant in their progress toward ACA implementation.

Just roll with it. What’s next? The 4th circuit. The two Virginia cases will be heard by the same appeals panel (three judges selected at random). While DOJ will appeal in the 11th circuit, the 4th circuit will most probably have the privilege of issuing the first appeals ruling regarding the individual mandate.

— Eva Marie Stahl, Policy Analyst