With the Final Four schedule settled, the March Madness continues with the U.S. Supreme Court oral arguments of the Patient Protection and Affordable Care Act (“ACA”) this week. The Bipartisan Policy Center’s Health Project is following the arguments closely to help address the uncertain future of the health care system. The Court’s decision will have a major impact on how we are addressing uncompensated care for our country’s hospitals and health professionals.
Regardless of the outcome, the BPC Health Project will continue to help states with their health system solutions, continue efforts to improve the quality of health care services through the use of health information technology and the identification of the supply and demand of the health care professional workforce in a new integrated delivery system. There are four issues before the Supreme Court:
- The constitutionality of the individual mandate
- Whether the mandate is severable from the rest of the ACA
- The constitutionality of the Medicaid Program eligibility expansion
- Whether the case is ripe for argument
Today, Monday, March 26, 2012, the Court heard oral argument addressing the last issue – whether the case was brought to court too soon, as the Fourth Circuit decided last year. Day 1 Oral Argument Snapshot: – 90 minutes on the Anti-Injunction Act (“AIA”) – Procedural hurdle — is the case is ripe for adjudication?
- At issue is whether the AIA applies to the individual mandate penalty. If it does, the Court may not consider the merits of this case until April 15, 2015, when the tax becomes enforceable.
– Quick Background on the AIA:
- The act employs a pay first, litigate later rule.
- The AIA states that “no suit for the purpose of restraining the assessment or collection of any tax shall be maintained in any court by any person.”
- It was designed to make sure that the federal government’s collection of taxes was not easily disrupted by lawsuits.
– Why would the court rule that the tax falls under the AIA?
- They decide that it is a tax and no exception applies that allows the Court to hear the case.
- They want to avoid a ruling in a presidential election year.
– Likelihood of ruling that the AIA applies to the individual mandate penalty: Unlikely.
- Both sides agree that the mandate penalty is not a tax for these purposes. In fact, the Court appointed a Friend of the Court to argue that the Anti-Injunction Act barred litigation of this case at this time.
– During oral argument, there were two basic questions considered about whether the individual mandate penalty falls under the AIA:
- Is the penalty a “tax” so that it falls under the AIA language prohibiting a Court from “restraining the assessment or collection of any tax”?
- Is the AIA a jurisdictional statute – meaning, does the Court have jurisdiction over the case?
– Questions from the justices during the oral argument hearing seemed to indicate that the Court is prepared to make a distinction between a “penalty” for regulatory purposes and a “tax” for revenue-raising purposes. Certain justices seemed to question that the individual mandate penalty was a “tax” because it did not intend to raise revenue. As Justice Ginsburg stated, if the individual mandate is successful “nobody will pay the penalty and there will be no revenue to raise.” – Chief Justice John Roberts noted that the Anti-Injunction Act didn’t stop the Supreme Court from ruling on the constitutionality of Social Security. “It’s a case quite similar to this in which the constitutionality of the Social Security Act was at issue, and the government waived its right to insist upon the application of this Act.”
- Supreme Court Oral Arguments, Day 1: What We’re Reading, March 26, 2012
- The Many Legal Barriers Standing in the Way of Health Care Reform, March 16, 2012
- Does Health IT Reduce Costs or Not?, March 14, 2012
- Regulatory Roundup, March 6, 2012