A Closer Look at the Florida Ruling – Say Ahhh! A Children’s Health Policy Blog

(This blog originally appeared on the Health Policy Hub)

By Eva Marie Stahl, Community Catalyst

Vinson toasts anti-ACA supporters with tea

Alas, the
Judge Roger Vinson (Florida v. HHS) ruling is here. The Florida-led case
remains the media darling of the handful of cases challenging health reform
that are rolling through the Federal courts in various circuits across the
country. The Florida-led plaintiff list (those opposing the law) brags of 26
states; this case represents a larger Republican strategy to challenge the
almost year old health reform law. The plaintiffs argue that the individual
mandate (or the provision that all individuals hold health insurance by 2014
and also termed the minimum coverage provision) infringes upon individual
liberty. No one should make you buy health insurance – alternatively, the Department
of Justice (DOJ) argues that no one should make you pay for those who decide
not to buy health insurance. Confused? We are just getting started.

Sit back and let your tea brew…

Many have waited
anxiously for this moment even though there was little doubt regarding the
outcome. Judge Vinson did, however, jolt the media with his far right leaning,
tea bag dipping, and Constitution defending language: “it is not hyperbolizing
to suggest that Congress could do almost anything it wanted. It is difficult to
imagine that a nation which began, at least in part, as the result of
opposition to a British mandate giving the East India Company a monopoly and
imposing a nominal tax on all tea sold in America would have set out to create
a government with the power to force people to buy tea in the first place.”

Vinson’s stance is most striking because of his position
on what is termed ‘severability’; in other words, can the ACA stand without the
individual mandate? Vinson maintains that while he did not read the entire
Affordable Care Act (ACA) (no fair, we did), that it is clear to him that the
individual mandate is inextricably linked to the provisions of the ACA and was
the intent of Congress. Therefore, the entire law must be declared
unconstitutional because it cannot exist without the individual mandate (and
the individual mandate is unconstitutional).

Good news?

On that front, there remain questions about
implementation and the responsibilities of states. Did the Judge grant an
injunction? (No.) Do states need to implement the law? (Yes.) Will DOJ appeal
to the 11th circuit? (Yes.) Various legal minds are trying to sort through
these questions – however, the current analyses suggest that because Vinson
issued a declaratory judgment, there is no need for a ‘stay’ – or a requirement
that until the appeals process is complete, the law stays put on the books.
That is not to say that states won’t think this their ‘out’ – advocates must
continue to educate the public about the benefits of the law and move forward with
implementation. Jonathan Cohn does his best to summarize this confusing outcome
here.

In short, states are not off the hook. The ACA is still
the law of the land and unless SCOTUS rules otherwise, our work continues. It
is important to remember that as the public reaps the benefits of the law, they
will embrace it. This will give SCOTUS pause; overturning ACA will be
damaging to all Americans. It is our job to remind the public of a state’s need
to continue to work to insure millions of Americans, giving them greater access
to health care and better health.

Few commentators are touting the win for Medicaid as a
result of this ruling. Judge Vinson did tell the right wing to back off of
Medicaid – he maintains that there is no legal foundation to their argument
that states are being coerced into the program. This is encouraging news for
advocates who are working tirelessly to protect a vital program for vulnerable
populations.

Keep the context.

The ruling differs from that of Judge
Henry Hudson (Virginia v. Sebelius) issued this past December.  Hudson did
not go as far as Vinson in his ruling – although Hudson claims that the
individual mandate is unconstitutional, he does not maintain that the entire
law is null and void. It is important to put all of this into context. These
are two rulings of four – the two opposed to the ACA are both from Republican
appointed judges in more right leaning circuits (yes, this is part of a
Republican strategy as to where they filed cases) while the two rulings in
support of the ACA come from Democratic appointed judges – and judges have
thrown out 12 cases due to a lack of merit. So, the rulings scoreboard reads
2-2 and we are not even to the seventh inning stretch.

Therefore, the most important ‘take away’ from Vinson is
that this is one piece of a larger judicial process – more rulings will be
unveiled before the Supreme Court makes its determination regarding the
constitutionality of the ACA. However, as pointed out by our own Michael
Miller
, the ruling is fodder for Republicans to feed their far right base and
motivate newly reddened states to hold defiant in their progress toward ACA
implementation.

Just Roll with it.

What’s next? The 4th circuit. The two
Virginia cases will be heard by the same appeals panel (three judges selected
at random). While DOJ will appeal in the 11th circuit, the 4th circuit will
most probably have the privilege of issuing the first appeals ruling regarding
the individual mandate.

The views expressed by Guest Bloggers do not necessarily reflect the views of the Center for Children and Families.

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