Federal Judge Roger Vinson heard arguments from U.S. Department of Justice and the attorneys for the state of Florida and the other 19 states using the federal government over the Affordable Care Act (ACA) (State of Florida v. U.S. Department of Health and Human Services, 10-cv-00091). DOJ had 6 attorneys, States had 18 people, including the Attorney Generals for Alabama, Utah and Florida. Republican candidate for Florida Attorney General, Pam Bondi, sat in the audience. Vinson listened to the Feds defend their motion to dismiss the lawsuit and the States countered.
The DOJ attorney argued that while the states had a right to disagree over the policy that don’t have the Constitutional right to challenge how the Federal government spends its money. He argued that the ACA is an expansion of the existing Medicaid program and that Congress has the right to modify that program as it sees fit. He had case law (South Dakota v. Dole and New York v. United States) to back up his statement that no court has ever ruled against that point, which he said undermined the States point (count 4) that they were being coerced into the expansion. The ACA falls within the spending power of Congress and is not coercive, according to DOJ.
DOJ also pointed out that the federal government will substantially increase its funding for the new Medicaid services, reimbursing 100% through 2016 and gradually declining to 90% in 2020 and beyond.
Judge Vinson asked about coverage of illegal immigrants. The DOJ attorney said that they aren’t covered under the ACA.
Vinson later said that the 13th Amendment, which let the U.S. Senators be elected by popular vote, denied the states any direction representation in Congress. The DOJ replied by calling the idea that somehow the states have been disembodied as “revolutionary” and an “odd notion” with no limit to it.
The DOJ also argued that the court lacks jurisdiction over states’ challenges to the minimum coverage provision. Because the ACA doesn’t go into effect until four years from now, the two individuals named in the suit, Mary Brown and Kaj Ahlburg, have suffered no injury.
Then there was discussion over whether individuals are being taxed or penalized for not having the minimum coverage. Under ACA, those who don’t have health insurance will be penalized on their tax returns.
Vinson brought up the states’ point that people are in essence being taxed for not doing something and while the Constitution gives Congress power under its Commerce clause, how can it tax non-activity? Commerce is a business activity….not non-activity.
The DOJ argued that that health care is unique. Everyone participates; they have no control over when they need it; and may or may not pay for it. “No one is a bystander.” The ACA regulates how someone pays for his health care and thus qualifies as commerce.