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State of Florida, et al. v.  United States Department of Health and Human Services (11th Cir. August 12, 2011)

In a 304-page decision, the Eleventh Circuit Court of Appeals has held that the 2010 law requiring all Americans to purchase health insurance, strongly favored by President Obama, was unconstitutional.

The plaintiffs consisted of 26 states, two private individuals and the National Federal of Independent Businesses (NFIB).  The defendants consisted of the HHS, the Departments of Labor and Treasury.  The plaintiffs challenged the constitutionality of the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 119 (2010), amended by Health Care and Education Reconciliation Act of 2010 (“HCERA”), Pub. L. No. 111-152, 124 Stat.1029 (2010).  The Act requires individual Americans who do not qualify for Medicaid or Medicare purchase insurance through private health insurers. The plaintiffs contended that such a mandate violated the constitutional rights of individuals.

The 11th Circuit decision, decided by a divided three person panel, held that “the individual mandate contained in the Act exceeds Congress’s enumerated commerce power”:  “What Congress cannot do under the Commerce Clause is mandate that individuals enter into contracts with private insurance companies for the purchase of an expensive product from the time they are born until the time they die.”

In a lengthy dissent, Circuit Judge Stanley Marcus argued that the majority ignored the “undeniable fact that Congress’ commerce power has grown exponentially over the past two centuries, and is now generally accepted as having afforded Congress the authority to create rules regulating large areas of our national economy.”

The Eleventh Circuit did hold portions of the law were constitutional, whereas the District Court had held that the entire law was indivisible, and therefore void in its entirety.  It upheld portions of the law requiring medical insurance to be extended to children of insureds through age 26 and the expansion of Medicaid discounts.

It is expected that the government will seek a review by the full Eleventh Circuit and potentially appeal to the United States Supreme Court.

A copy of the 304-page opinion can be accessed here.

Sarah Delaney and Mike Glascott