After a week of celebrating the second anniversary of the Affordable Care Act (ACA), it is increasingly difficult to dismiss all the good that health reform is doing. Whether you are someone with a pre-existing condition who now has access to health insurance coverage or you are under 26 years old and can remain on your parent’s health policy or you are no longer burdened with co-pays for preventative care visits, the good touches us all in some way. With 2014 promising even more coverage gains for people from all walks of life, we must be steadfast in our support of the ACA.
The Supreme Court begins hearing oral argument today and those who oppose health reform are determined to undermine all the benefits of the law. Since anniversary week demonstrated how health care reform is working, it’s worth asking ourselves; how did we end up in the nation’s highest court?
The case. Directly after the signing of the Affordable Care Act (ACA) in March 2010, then Florida Attorney General (AG) Bill McCollum filed a lawsuit against the federal government. McCollum and others argue that the individual responsibility requirement (IRR) is unconstitutional (in other words, the federal government cannot tell you what to buy). While the IRR is the focal point of the legal challenge, McCollum and friends (plaintiffs) also accuse the federal government (defendants) of coercing states to participate in the Medicaid program, maintaining that the Medicaid expansion is unconstitutional. Profiting from shifting political winds, McCollum swiftly built a list of co-plaintiffs to include 26 states, the National Federation of Independent Business (NFIB), and a handful of private parties.
During 2010-2011, multiple legal challenges unfolded in addition to Florida ― most notably in Virginia (4th circuit) and Michigan (6th circuit). However, Florida became the poster child of opposition due to its vast plaintiff list. The Florida case traveled through the court system in a relatively predictable manner. It began in the U.S. District Court in Northern Florida where Judge Roger Vinson, a known conservative judge, struck down the IRR and subsequently the entire law, granting conservatives a big win. The Obama administration appealed the Vinson decision, sending the case to the 11th Circuit Court of Appeals in Atlanta. A three judge panel ruled 2-1 that the requirement to purchase insurance was unconstitutional. The panel, however, found the IRR to be severable from the rest of the law, meaning that all other ACA provisions remain intact. The appeals panel also confirmed that the Medicaid program is a legitimate federal mechanism to expand coverage to the uninsured, dismissing the charge of coercion as “more rhetoric than fact.” The Obama administration then appealed directly to the Supreme Court.
To better understand the pathway to the Supreme Court, see this flowchart.
During these two years of legal wrangling, it is noteworthy that not all judges followed party lines. Two high profile conservative judges upheld the IRR. Sixth Circuit Judge Jeffrey Sutton, a former law clerk for Justice Antonin Scalia, and DC Circuit Judge Laurence Silberman supported IRR constitutionality. These actions suggest that even the most conservative Supreme Court justices have a legal path to constitutionality of the ACA.
The timeline. Beginning today, the Supremes will hear three distinct arguments over three days and six hours. This is the longest allotted time for oral argument in 45 years. While the second and third days focus on arguments raised by the Florida case, the first day allots time to address the Anti-Injunction Act (AIA), an issue raised in a separate case heard in the 4th circuit. By doing this, analysts believe that the court is trying to represent all the legal challenges being pursued nationwide. The week’s schedule shapes up like this:
Monday: Anti-Injunction Act: 90 minutes Tuesday: Individual Responsibility Requirement: 120 minutes Wednesday: Severability of the Individual Responsibility Requirement: 90 minutes and Medicaid expansion: 60 minutes
Now that we’ve reviewed how we got here, you might ask, who’s who?
The legal eagles… For those of you unfamiliar with the lawyer food chain, lawyers who specialize in Supreme Court practice are few in number and highly skilled. High-profile cases, such as this one, are the stuff of lawyer dreams.
In one corner, you have the heavyweight, seasoned attorney representing the attorneys general and friends. In the other corner, you have the intense, straight shooter solicitor general representing the defense.
Paul Clement. According to a recent New York Magazine article on Clement, he is a quiet and gifted legal mind, noted for his ability to remove the partisan element from an argument. His technique includes targeting the Justice that he needs most; he has made more than four Supreme Court appearances this year alone. Watch (or listen) for him to hit hard on Justice Anthony Kennedy ― viewed as the swing vote on the Court.
Solicitor General Verrilli. Verrilli is the newly appointed solicitor general, replacing Elena Kagan (newest Supreme Court justice). He is known for his hard-hitting work on first amendment rights related to the telecommunications and music industry as well as his work on the rights of death row inmates. He is gifted at cutting through jargon, articulating the basic argument in understandable terms.
The decision makers… The Supremes. The justices are often described as split 4-4 with Justice Kennedy as the decider (or swing vote). To understand more about the justices, who appointed them and their political leanings, scroll over their photos here. All of those stereotypes aside, the anti-ACA case is an interesting one that tests the conservatives in the pack. (See Michael Miller’s blog here.) Analysts feel relatively certain as to how the liberal slated crew will cast their votes but less sure about how Justice John Roberts (who likes to live in the majority and drive the opinion) and Justice Antonin Scalia (who’s past rulings are cited in favor of retaining the IRR).
Stay tuned this week for more coverage of these hearings. Look for our daily blogs and check out our Supreme Court resource page.
— Eva Marie Stahl, Policy Analyst