The Supreme Court and the Affordable Care Act

After the Affordable Care Act was enacted in March 2010, numerous lawsuits challenging several provisions of the landmark law were filed in the federal courts. Many of those cases were dismissed, but some federal appellate courts issued decisions on the merits of the law. In November 2011, the United States Supreme Court agreed to consider the constitutionality of two major provisions of the law: the individual mandate and the Medicaid expansion. The Court heard arguments on these issues on March 26-28, 2012. It upheld the law on June 28, 2012.

• A Closer Look: The Supreme Court's Health Care Decision explains what was at stake in the case against the Affordable Care Act, how the Supreme Court ruled, and the impact of the ruling on the law. (August 2012)
• The Supreme Court Decision: What It Means for Medicaid gives an in-depth look at the Court's ruling on Medicaid and what advocates can do to make sure their state expands coverage. (August 2012)
• Families USA's news release on the decision.

The resources listed below include:

• Talking Points
• Background Materials
• What's at Stake?
• Amicus Briefs

Talking Points

• Talking about the Individual Mandate provides an overview of what the individual mandate means for Americans. (August 2012)
• Talking about the Affordable Care Act and the Supreme Court (Families USA, January 2012)

Background Materials

• Why Health Care Isn't Broccoli—Some Basic Economics (Henry Aaron, The Brookings Institution)
• What Makes Health Care Different (Washington Post Op-Ed)
• Health Care and the High Court: An Advocate’s Guide to Florida, et al. v. U.S. Department of Health and Human Services, et al. (Families USA, March 2012)
• How Health Reform Helps the States is a series of short fact sheets with state-specific data showing how residents have benefited from the Affordable Care Act so far and how they'll continue to benefit as the law is implemented. (Families USA, February 2012)
• The Kaiser Family Foundation prepared a primer on the arguments.
• The Supreme Court's website.

What's at Stake?

• Supreme Court Ruling Could Turn Health Care Topsy-Turvy provides an excellent overview of what will be lost if the law is repealed (Congressional Quarterly Healthbeat News)
• Being Uninsured Is a Mandate, Too, by former Michigan Governor Jennifer Granholm (Politico)
• The Medical Caste System of America (Reader Supported News)

Amicus Briefs

Dozens of amicus (“friend of the court”) briefs were filed in the case. Families USA has signed two amicus briefs.

• Upholding the Minimum Coverage Provision (also called the individual mandate or individual responsibility provision)
• Upholding the Medicaid Expansion
• Signers of Amicus Briefs in Support of the Individual Responsibility Provision or Medicaid Expansion lists the names and affiliations of most of the attorneys and academics who have signed on to amicus briefs, listed alphabetically by state. Since there were so many briefs filed in the case, it is possible that not all signers are included. (March 2012)

More Briefs

• For more briefs, including the main briefs filed by the federal government, the state attorneys general and private parties opposing the law, and many amicus briefs, check the ACA Litigation Blog.

Lower Court Decisions
Four federal appellate courts have considered the merits of the Affordable Care Act.

• The Sixth Circuit and the DC Circuit upheld the law in its entirety.
• The Fourth Circuit dismissed a challenge as premature.
• The Eleventh Circuit struck down the individual responsibility provision but left the rest of the law in place. The decision of the Eleventh Circuit is under review by the U.S. Supreme Court.