Federal appeals court affirms healthcare reform

On Nov. 8, the fourth federal appeals court to hear legal challenges to the Affordable Care Act (ACA), the federal healthcare reform law passed in March 2010 by the U.S. Congress and signed into law by President Barack Obama, made its ruling. In a 2-to-1 decision, a panel of the U.S. Court of Appeals for the District of Columbia Circuit agreed with a lower court judge’s finding that Congress had the authority to enact the individual health insurance mandate, which requires that nearly all Americans obtain health insurance or pay a penalty.

Writing for the majority, Senior Judge Laurence H. Silberman, an appointee of President Ronald Reagan, found that the Commerce Clause of the U.S. Constitution supported the individual mandate, even as he acknowledged that the individual mandate represented some degree of encroachment on individual liberty.

“The right to be free from federal regulation is not absolute and yields to the imperative that Congress be free to forge national solutions to national problems,” Silberman wrote, adding that the fact that Congress may never have issued an individual mandate to purchase something before now, a central argument for many opposing the law, “seems to us a political judgment rather than a recognition of constitutional limitations.”

Interestingly, the court touched on one of the issues that plaintiffs bringing anti-ACA lawsuits have brought before the federal courts, when Judge Silberman wrote in his ruling that “Congress can regulate even purely local, intrastate economic behavior so long as, in the aggregate, it substantially affects interstate commerce.”

In making its decision, the D.C. court turned back an anti-ACA effort brought forward by four individuals represented by the American Center for Law and Justice, a conservative litigation organization founded by evangelist Pat Robertson. The plaintiffs had argued that the individual mandate exceeded the limits of Congressional power and impeded their free exercise of religion.

This makes the third federal appellate ruling to support the ACA, either directly or procedurally. Appeals courts in Cincinnati and Richmond earlier this year also fully affirmed the healthcare law, while the Eleventh Court of Appeals in Atlanta ruled against the individual insurance mandate on Aug. 12, though that court also determined that the ACA as a whole was constitutional. In the case of the Fourth Court of Appeals in Richmond, that court ruled in September that the plaintiffs in the combined cases before it lacked the legal standing to bring their cases. Still, some legal experts said they believed that the Atlanta case was the one most likely to be heard by the Supreme Court.

In all three previous cases, the plaintiffs have already petitioned the U.S. Supreme Court to rule on the individual mandate issue. The nation’s highest court could decide as early as this week to put an ACA-related case on its docket; if it does so, it could render a decision by the end of next summer. Mark Hagland is Editor-in-Chief of Healthcare Informatics, a resource for healthcare CIOs.

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