As the Patient Protection and Affordable Care Act (ACA) heads to the 4th U.S. Circuit Court of Appeals, President Barack Obama may have lucked out. Of the three judges who were randomly chosen to hear the case, two are Obama appointees; the third was appointed by President Bill Clinton. In one case, the federal government is appealing a ruling that struck down the law’s requirement that all Americans must purchase health insurance or pay a penalty. In the second case, Liberty University is appealing another judge’s ruling that upheld the healthcare reform law.
It’s highly likely that this court will uphold the ACA, because the rulings in the lower courts have closely tracked the judges’ judicial ideology. Conservatives tend to strike down the law; liberal judges tend to uphold it. After this, it’s likely that the Virginia attorney general will take the case to the United States Supreme Court, where swing voter Justice Anthony Kennedy could make or break the fate of the ACA.
Acting U.S. solicitor general Neal Katyal, who is representing the Obama administration, said that the law targets “problems in the national healthcare system that states individually have proven unable to solve effectively.” The legislation, intended to make healthcare coverage more affordable for Americans, also reduces the current uncompensated care that results in higher premiums for people who already have insurance. “The Constitution grants Congress the power to regulate conduct that substantially affects interstate commerce,” Katyal wrote in his brief. “The requirement that participants in the health care market have insurance to pay for the services they consume is thus a quintessential exercise of the commerce power.”
The ACA’s supporters maintain that the law falls within Congress’s power to regulate interstate economic activities. Opponents claim that the ACA represents a dramatic expansion of the federal government’s authority under the Constitution’s commerce clause. The law lets the government regulate economic activities and also the inactivity of those who might opt not to purchase health insurance.
“The purpose of health insurance is to pay for expenses incurred in the health care services market,” Katyal said in his brief. “That some participants in the healthcare market may be ‘passive’ in the insurance market – in the sense that they may not currently have insurance – has no constitutional significance.” Buying and selling health insurance is a national economic activity, according to Katyal. “The modern health care system operates across state boundaries. Most health insurance is sold or administered by national or regional companies that operate interstate, and pays for medical supplies shipped in interstate commerce,” he said.
E. Duncan Getchell, Virginia’s solicitor general, argued in his brief that the federal healthcare reform law’s individual mandate clashes with a state law seeking to protect the right of Virginians to decide for themselves whether to buy health insurance or remain uninsured. “Because the claimed power to order a citizen to purchase a good or service from another citizen has no principled limit, it violates the … limits of the commerce clause,” Getchell wrote.
“The fact that the government is sending the solicitor general of the United States to argue the case does reflect how important the government considers this case to be,” said Lisa Blatt, an appeals lawyer at Arnold & Porter LLP in Washington. Typically, the U.S. solicitor general usually only argues cases before the U.S. Supreme Court.