Supreme Court To Review Case Challenging Health Reform Law & Supreme Court surprise: Court will also hear Medicaid challenge

Fri Nov 25 06:27:06 PST 2011

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Chapter of the American Academy of Emergency Medicine

November 14, 2011

Supreme Court To Review Case Challenging Health Reform Law  

CaliforniaHealthcare
<http://www.californiahealthline.org/articles/2011/11/14/supreme-court-to-re
view-case-challenging-health-reform-law.aspx#ixzz1diP1PrL0> 

On Monday, the Supreme Court announced that it will review the legal
challenges against the federal health reform law in early spring 2012,
Reuters reports.

The high court posted its decision online this morning. Four lawsuits
challenging the law were presented to the justices, but the court selected
only the multistate lawsuit filed by 26 states and the National Federation
of Independent Business (Vicini, Reuters, 11/14). The Supreme Court also
announced it has accepted HHS' petition to review the overhaul (Supreme
Court summary dispositions release, 11/14).

Background on Lawsuit

In the multistate lawsuit, a three-judge panel for the 11th Circuit Court of
Appeals in Atlanta on Aug. 15 ruled that the individual mandate is
unconstitutional. The 11th Circuit appeals court was the first to rule
against any part of the law.

The plaintiffs in the case argue that the individual coverage mandate
exceeds Congress' power to regulate interstate commerce. In addition, the
plaintiffs argue that a provision of the law requiring states to expand
Medicaid coverage to adults with incomes up to 133% of the federal poverty
level is unconstitutional and "coercive."

The court, in a 2-1 ruling, struck down the individual mandate but left the
Medicaid expansion intact (California Healthline, 8/15).

Details of Court's Acceptance of Case

The high court said it consolidated the petitions for writ of certiorari
from the two parties to review the issue of "severability." The issue stems
from a question about the lack of a severability clause in the health reform
law, which would allow one part of the law to be struck down without
jeopardizing the entire law.

In addition, the court will review whether the suit is barred by the
Anti-Injunction Act, which prohibits the court from hearing a suit until the
plaintiffs can prove harm. In this case, it might mean the case could not be
heard until 2014 -- when the individual mandate and, subsequently, the
penalty for not obtaining health insurance -- takes effect (Supreme Court
summary dispositions release, 11/14).

The justices will allow about five and a half hours for oral arguments in
the case (Haberkorn, Politico, 11/14).

Reactions

In a statement, White House Communications Director Dan Pfeiffer said, "We
are pleased that the court has agreed to hear this case." He added, "We know
the Affordable Care Act is constitutional and are confident the Supreme
Court will agree" (Holland, AP/Boston Globe, 11/14).

In a tweet, House Majority Leader John Boehner (R-Ohio) said, "Pleased to
hear #SCOTUS will rule on ObamaCare. The #hcr law is destroying jobs in.
America & must be repealed" (Boehner tweet, 11/14).

Karen Harned, executive director of the NFIB Small Business Legal Center,
said, "We are confident in the strength of our case and hopeful that we will
ultimately prevail. Our nation's job-creators depend on a decision being
reached before the harmful effects of this new law become irreversible"
(Reuters, 11/14).

Timeline

The Supreme Court likely will hear arguments on the case in March 2012.

A decision in the case is likely by the end of the term in late June
(Jackson, USA Today, 11/14).

November 14, 2011

Supreme Court surprise: Court will also hear Medicaid challenge

Thehill.com
<http://thehill.com/blogs/healthwatch/legal-challenges/193483-supreme-court-
surprises-both-sides-of-health-suit-by-hearing-medicaid-challenge> 

Lawyers on both sides of the lawsuits over President Obama's healthcare law
were caught off guard Monday when the Supreme Court said it would debate
whether the law's Medicaid expansion is constitutional.

The high court was widely expected to take up the law's individual mandate,
and to take the case filed by 26 states and the National Federation of
Independent Business. But the court's decision to also hear the states'
Medicaid challenge came as a surprise to the healthcare law's critics as
well as its supporters.

"I don't really know what that signals, but that signals something," said
Randy Barnett, a Georgetown University law professor who represents NFIB.

The court rarely takes up issues that have not split lower courts, but the
states haven't gotten anywhere with their Medicaid arguments. The district
court and the appeals court in the 26-state suit both said the Medicaid
expansion is constitutional. Both also struck down the mandate.

"I guess they're just willing to consider everything," Barnett said.

Tim Jost, a Washington and Lee University law professor who supports the
healthcare law, was "surprised and disappointed" that the court took up the
Medicaid challenge. A ruling against the expansion would have more dramatic
implications than a ruling against the mandate, he said.

Simon Lazarus, policy counsel at the National Senior Citizens Law Center,
echoed that view.

"That would be enormously dramatic, which is a good reason to think they
won't do it," he said. "It would invite copycat attacks on myriad federal
requirements."

Lazarus and other experts cautioned that taking up the Medicaid challenge
doesn't necessarily mean the Supreme Court is poised to accept the states'
arguments - it could simply mean that enough justices thought the question
was worth considering.

"I think the grant strongly suggests that they have interest in the issue,"
said Greg Katsas, who represents NFIB. "I don't think you can go so far as
to say it signals that the states are likely to win, but it does signal
they're viewing that as a serious question."

Ilya Shapiro, an attorney with the libertarian Cato Institute, said
upholding the Medicaid expansion could help make a rejection of the
individual mandate seem more tailored and less like a broad attack on the
healthcare law.

"It might make them look balanced at the end," he said.

The healthcare law expands Medicaid so that everyone with an income below
133 percent of the federal poverty level is eligible for aid. States must
adopt the new eligibility threshold if they want to remain in Medicaid, and
the federal government will initially pay the entire cost of covering the
newly eligible patients. 

The 26 states say the requirements amount to "coercion." But the 11th
Circuit Court of Appeals said the federal government has broad power to
change the terms of Medicaid and states must adhere to new terms or quit the
program altogether.

Lazarus said there is a "noticeable fear and loathing" in conservative legal
circles of the federal government's authority to attach strings to its
funding.

"Paul Clement's brief cleverly pushed all of those buttons," Lazarus said.
Clement, a former solicitor general, is the lead attorney for the states.

Clement argued that the federal government can attach new requirements to
new streams of federal funding, but shouldn't be able to tack on more
Medicaid mandates simply because states initially agreed to participate in
the program. The reform law "essentially holds the states hostage," he wrote
in the states' request for a Supreme Court hearing.

Marcus Williams &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service

Contact us at: calaaem.news.service1 at gmail.com

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