iPhone app iPad app Android phone app Android tablet app More

Featuring fresh takes and real-time analysis from HuffPost's signature lineup of contributors
GET UPDATES FROM Douglas L. McSwain
 

Legal Forecast: The Supreme Court Won't Strike Health Reform - Part I

Posted: 11/30/11 11:18 AM ET

The legal forecast for the Affordable Care Act -- "Obamacare" -- is partly sunny skies. While the Supreme Court recently accepted the Act for review, the Court is not expected to hurl lightning bolts striking down any part of the Act. (Of course, this is only a prediction; there are no guarantees.)

But, for both constitutional and pragmatic reasons, the Act appears more than capable of weathering the attacking storms.

Most of the Act Will Stand for Pragmatic Reasons

(Or, What Isn't Challenged Won't Be Thrown Out)

First, the Court chose to review only two parts of the law -- the individual mandate and the Medicaid expansion. It's worth noting that the vast majority of the law is not being reviewed.

As discussed previously -- in Health Care Reform Is Here! -- the Act contains many free-market incentives and reforms that nearly all Americans would agree are desirable. For example:

  • Incenting innovations in health care by paying for value and performance (i.e., positive outcomes) instead of "fee for service," which emphasizes quantity over quality
  • Developing measures of quality in health care based on medical evidence
  • Building America's health care workforce with a focus on primary care workers, whose services are often less costly
  • Creating transparency so consumers can better assess their health coverage options and the quality of their health care providers
  • Fostering flexibility in health coverage options by allowing the sale of insurance across state lines and development of consumer-owned insurance co-ops
  • Imposing tighter fraud, waste, and abuse controls in programs like Medicare and Medicaid

These are just a few of the positive reforms not before the Court. There are numerous others. To strike the entire Act would essentially "throw the baby out with the bathwater." Therefore, the forecast for the Act's survival is clear skies, if not for all of it, then for the greatest part.

The Individual Mandate Will Stand for Constitutional & Pragmatic Reasons Too

Despite dire predictions, the skies are not bleak for the much-discussed individual mandate that requires everyone to buy health insurance or pay a penalty.

Here's why: If the Court struck the mandate, the legal support for other unrelated federal laws (such as the federal drug laws and laws authorizing the continued detention of sexually dangerous prisoners) would be called into question as well.

Recently, the Court sustained these federal laws on the same legal grounds that support the individual mandate, so it would be a stretch to predict the Court would reverse course and undercut itself. Specifically:

  • The Commerce Clause: In 2005's Gonzales v. Raich, the Bush administration defended the federal drug laws against a challenge by marijuana growers and users who claimed California's state-wide legalization of medicinal marijuana should trump federal laws. The challengers argued the federal drug laws exceeded Congress' authority to regulate commerce, but the Court rejected this, holding that Congress has broad power under the Commerce Clause, including the power to regulate even "purely local activities" that, when considered cumulatively, "have a substantial effect on interstate commerce."
  • The Necessary & Proper Clause: In 2010's U.S. v. Comstock, the Obama administration defended federal laws authorizing the continued detention of federal prisoners who completed their sentences but were mentally deranged or sexually dangerous to others. Several prisoners challenged Congress' authority to hold them once they served their sentences, but the Court rejected this, reasoning that because Congress was empowered to imprison criminals, continuing the civil detention of deranged and sexually dangerous individuals was a "necessary and proper" extension of that power.

Both Raich and Comstock sustained the federal laws with solid majorities (greater than 5 out of 9 Justices including concurring Justices), which suggest that when considering health care reform, the Court will likely have another strong majority adhering to a traditionally broad interpretation of the "Commerce" and "Necessary and Proper" Clauses of the Constitution.

This is true even though the Supreme Court's makeup has changed somewhat since those cases were decided. In 2010, Justice Elena Kagan replaced John Paul Stevens on the bench, but she is not likely to read these Clauses any less broadly than her predecessor. As Solicitor General in the Obama Justice Department, she argued the "necessary and proper" defense of the federal laws before the Court in Comstock.

Despite the insistence of "Obamacare" opponents who argue Kagan should recuse herself because of her former role as Solicitor General (and similar calls on the other side for Justice Clarence Thomas's recusal due to his wife's vocal Tea Party involvement), neither Justice will likely recuse. Indeed, neither recused when the Court accepted review of "Obamacare": a good indication they won't recuse when the case is heard.

Opponents claim the "Commerce" and "Necessary and Proper" Clauses do not support the mandate because no commerce is involved in people not buying health insurance. But Congress has found that tens of thousands of Americans being uninsured impacts the entire market for health insurance. Even if some of the Justices disagree with this, the Court does not function as a "super" legislature, and will refrain from scrutinizing the correctness of legislative facts. It will not lightly usurp Congress' fact finding role, nor undermine the longstanding constitutional doctrine that favors broad powers of Congress to regulate national markets.

While it is true that Congress does not often penalize non-purchasers in a market, a majority of the Court will predictably adhere to this traditional constitutional principle articulated by Justice Scalia in Raich: "where Congress has the authority to enact a regulation of interstate commerce, it possesses every power needed to make that regulation effective." "Every power" could easily include imposing a monetary penalty on those who do not buy insurance.

Finally, striking down the individual mandate would seriously undermine many other longstanding federal laws. Few people, and especially conservatives, could stomach a ruling that undercuts the validity of the federal drug laws (Raich), or laws detaining sexually dangerous felons (Comstock). Even fewer want to erode the civil rights laws or minimum wage and child labor laws, which have also been upheld by a broad reading of Congress' "commerce" and "necessary and proper" powers.

All this suggests that at worst, partly cloudy skies are ahead for the individual mandate. Even if a few Justices favor lightning, their preferences face the strong headwinds of judicial restraint.

Stay tuned, Part II of Legal Forecast will check the barometer on health reform's Medicaid expansion and the Anti-Injunction Act, which could bar the Court's review of "Obamacare" altogether.

 

Follow Douglas L. McSwain on Twitter: www.twitter.com/DouglasLMcSwain

The legal forecast for the Affordable Care Act -- "Obamacare" -- is partly sunny skies. While the Supreme Court recently accepted the Act for review, the Court is not expected to hurl lightning bolts ...
The legal forecast for the Affordable Care Act -- "Obamacare" -- is partly sunny skies. While the Supreme Court recently accepted the Act for review, the Court is not expected to hurl lightning bolts ...
 
 
  • Comments
  • 16
  • Pending Comments
  • 0
  • View FAQ
Comments are closed for this entry
View All
Favorites
Recency  | 
Popularity
photo
DismayedRepub
300Mm/s Not just common sense, it’s the law
11:46 PM on 01/01/2012
The SCOTUS lives on precedent. Never before has our government required us citizens to buy something. There is no precedent for the government to require that we participate in commerce and I think the court will see it for what it is, an unconstitutional expansion of government power and it will be shot down.
11:38 PM on 11/30/2011
With the supreme court and their resent ruling that corporations are people too..allowing super pacs to take over this country. I would not put it past them with a vote of 4 to 5 against along party lines to rule against the affordable Heathcare act. And again they would be wrong... I am hoping that doesn't happen.
HUFFPOST SUPER USER
Attila Tikkun
04:29 PM on 11/30/2011
Wouldn't an alternate ground be that the individual "mandate," isn't a mandate, per se, in that it is not a command. An individual's failure to have health insurance, in some cases, would result in an additional tax charge on the individual (whether as a penalty or a surcharge.) Isn't that right? Congress has a plenary power to tax and spend for the general welfare, [Helvering v. Davis, 301 U.S. 619 (1937)]. The tax is intended to defray, in part, the costs of the program. The individual might make an economic decision that paying the tax penalty would be less expensive than procuring health insurance (unless s/he got seriously ill, G-f.). Thus, it is an individual choice ultimately, albeit unpleasant, and not a Congressional command.
11:10 PM on 12/01/2011
Yes, the Supreme Court might treat the penalty for not getting health insurance as a "tax." Also, the Court might treat it as a "fee." In Legal Forecast Part II (forthcoming), we will examine the implica- tions of the Court treating the penalty as a "tax" or "fee." While Congress could have characterized the penalty as a "tax," it did not. The Court, following Congress' lead, may treat it as a penalty only and not a "tax." Several of the lower court rulings on the health reform law did just that. If the Court refuses to treat it as a "tax," it will not have the occasion to rule on whether the tax and spend power justifies the individual mandate. On the other hand, if the Court considers it a "tax," the Anti-Injunction Act may preclude the Court from reaching whether the power to tax and spend justifies the penalty. More on this point in Part II (forthcoming). Excellent comments that you've made, and it will be interesting to see how the "tax" angle plays out before the Court.
HUFFPOST SUPER USER
Attila Tikkun
12:03 AM on 12/04/2011
Very interesting, but question: does it matter what Congress characterizes the penalty as? If it's collected by the I.R.S. (or results in losing a deduction), isn't it taxation on a de facto basis, regardless of how it is labeled? I look forward to reading Part II.
02:33 PM on 11/30/2011
The Court would not require 5.5 hours for Oral Argument if they used the Clarence Thomas"silence is deadly" approach to jurisprudence. They could sit there weaving "cats craddles" amongst themselves or play jacks with the Court Attendants.
02:19 PM on 11/30/2011
One case would tend to contradict the authors premise. Bush V Gore. That case was completely political and had no basis in law or the constitution. I would not put it past the majority in the Supreme Court to do it again.
01:47 PM on 12/02/2011
Yes, but Bush v. Gore has been cited a grand total of zero times. The author's point seems to be that overturning the Affordable Healthcare Act would have inescapable repercussions on precedent for future rulings. Politics wouldn't enter into it unless the Court shucks its responsiblity entirely, which, given how self-destructive that would be, seems unlikely.
05:42 PM on 12/04/2011
Yes, this is the nature of "legal forecasting." There is a certain amount of predictability that inheres in case law precedent and judicial restraint. The Supreme Court could certainly veer off precedent; it wouldn't be the first time in history that it has. But, the "legal forecast" - based on current constitutional law precedent - as to the individual mandate, plus the doctrine of judicial restraint and the back-end political implications that would occur if the Court were to veer off-course, all point to "partly sunny skies" for the health care reform law before the Court. Part II of this Legal Forecast series on "Obamacare" will address some of the other legal issues before the Supreme Court, and they may shed even more light on what is to come. Stay tuned!
11:15 AM on 12/05/2011
It was destructive when they did exactly the same thing in Bush V Gore.
02:16 PM on 11/30/2011
Sorry, not "jurisdiction" rather "justification."
01:58 PM on 11/30/2011
You might also want to post an examination of another independent basis of jurisdiction: the taxing and spending clause. The court may find that the method to enforce the mandate, an approx. 2% increase on income, may be a legitimate exercise of that power.
HUFFPOST SUPER USER
beckjr2000
been there done that & tired of it
01:49 PM on 11/30/2011
Strictly wishful thinking on your part Lawyer McSwain. I don't believe it will hold up under either clause, that being my opinion.
photo
HUFFPOST SUPER USER
fightthapower
Brevity is the soul of wit....
01:04 PM on 11/30/2011
Great analysis!!