Litigation Update: the Affordable Care Act

The Affordable Care Act is now law, but controversy over the bill is far from over. Plaintiffs of all stripes — from nuns to businesses to Congress itself — have challenged Obamacare, as well as its implementation by the executive branch.

In a new report from the NCPA, Senior Research Fellow Ann Purvis outlines many of the cases surrounding the Affordable Care Act. Ongoing controversies include:

– The religious accommodation: The Little Sisters of the Poor, a group of nuns, are opposed to the requirement that their insurance plans offer contraceptive coverage. The Obama administration has issued an “accommodation” — if religiously affiliated groups object to the contraceptive mandate, the government itself will direct the insurer to provide contraceptive coverage. But the Little Sisters say that certifying their objections triggers provision of the services they find objectionable, doing nothing to relieve the law’s burden on their conscience. Does the law violate their religious liberty? The case is pending before the Tenth Circuit Court of Appeals.
– The Origination Clause: Revenue-raising measures (taxes) are required to originate in the House of Representatives, but the Affordable Care Act originated in the Senate. Because the Supreme Court deemed the individual mandate penalty a “tax” in the 2012 case that upheld the mandate, litigants contend the tax is invalid under the Origination Clause. The plaintiffs recently filed for a rehearing before the D.C. Circuit Court of Appeals.
– The Independent Payment Advisory Board (IPAB): The ACA created IPAB, a panel which makes Medicare budgetary recommendations. Those recommendations become law unless Congress and the president can agree to an alternative proposal. Coons v. Lew challenges IPAB as an unconstitutional delegation of congressional authority. Plaintiffs have appealed to the Supreme Court after an unfavorable ruling before the Ninth Circuit Court of Appeals.
– Premium subsidies: The IRS decided to grant premium subsidies to enrollees in federally-run exchanges, even though the text of the law only provides subsidies to those in state-run exchanges. Are the subsidies valid, or did the IRS exceed its authority? The Supreme Court will hear the case this spring.

The Supreme Court will hear King v. Burwell on March 4, 2014. If the Court rules in favor of the plaintiffs, the individual and employer mandates would be affected.

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