Skip to main content

Analysis

Plaintiffs' Standing Challenged in ACA Appeal

By John Commins  
   May 22, 2019

California-led defenders of the ACA say the plaintiffs are asking the court 'to do what Congress—after years of debate and deliberation—repeatedly refused to do: dismantle the entire Affordable Care Act.'

The Trump Administration and Texas-led states hoping to see the Affordable Care Act repealed judicially don't have the standing to gut the bill in its entirety, intervening Democratic attorneys general from 21 states said in a brief filed Wednesday.

The California-led defenders of the ACA told the 5th U.S. Circuit Court of Appeals that the plaintiffs are asking "this Court to do what Congress—after years of debate and deliberation—repeatedly refused to do: dismantle the entire Affordable Care Act."

"It is no secret that the plaintiffs, and their new-found allies in the federal Executive Branch, oppose the ACA as a policy matter," the interveners wrote. "But they can articulate no plausible legal ground for the breathtakingly broad policy change that they ask this Court to uphold under the guise of constitutional adjudication."

Specifically, the intervening AGs argued that:

  • The Texas-led plaintiffs have no standing to challenge the individual mandate, because no plaintiffs were injured by the provision when Congress eliminated the tax penalty for failing to buy insurance.
     
  • Despite a U.S. District Court ruling invalidating the individual mandate (along with the rest of the ACA) the provision is constitutional and similar to other laws passed by Congress.
     
  • Even if the lower court's ruling on the unconstitutionality of the individual mandate is upheld, the provision could still be severed from the ACA because Congress sought to keep every other provision of the ACA when it cut the tax to zero.

The 5th Circuit announced that it will hold oral arguments the week of July 8.

U.S. District Judge Reed O'Connor last December declared the entire ACA invalid, as the plaintiff states had requested. The ruling was appealed to the Fifth Circuit by the California-led coalition.

Since O'Connor's ruling, Wisconsin and Maine left the plaintiff coalition after Democratic AGs took office in those states following the November general elections.

Related: Hospital Groups Thump Trump DOJ on ACA Reversal

Related: DOJ Drops Its Partial ACA Defense, Argues Entire Law Should Fall

Related: Invalidating ACA Would Undercut Parts of Trump's Own Health Policy Agenda

Related: House Officially Intervenes in High-Stakes Case to Defend ACA

Initially, the Trump Administration's DOJ offered a partial defense of the ACA, arguing that most of the sprawling healthcare legislation should remain intact, even if the ACA's individual mandate were to be struck down in light of Congress zeroing out its tax penalty.

O'Connor's ruling invalidating the ACA went much further than what DOJ had urged. Earlier this year, however, DOJ reversed course and notified the appeals court that it agrees with the plaintiffs' argument and O'Connor's ruling, and would entirely abandon its partial defense of the ACA.  

Defenders of the ACA say a repeal of the sweeping law could adversely affect 133 million people, including 17 million children, with pre-existing conditions. In addition, invalidating the law would challenge the coverage of more than 12 million people who became insured under the ACA's Medicaid expansion.   

“(Plaintiffs) can articulate no plausible legal ground for the breathtakingly broad policy change that they ask this Court to uphold under the guise of constitutional adjudication.”

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

Photo credit: zimmytws / Shutterstock


KEY TAKEAWAYS

The 21 state AGs defending the ACA say the Texas-led plaintiffs have no standing to challenge the individual mandate, because no plaintiffs were injured by the provision when Congress eliminated the tax penalty for failing to buy insurance.

Even if the lower court's ruling on the unconstitutionality of the individual mandate is upheld, the intervening AGs argue that the provision could still be cut from the ACA because Congress kept every other provision of the act when it cut the tax to zero.


Get the latest on healthcare leadership in your inbox.