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Individual Mandate: 11th Circuit Wasn't Wrong, But it Wasn't Right Either

By Robyn Hagan Cain on June 28, 2012 | Last updated on March 21, 2019

Of all the appeals, in all the circuits, in all the country, the Supreme Court chose theirs.

Perhaps that's because the Eleventh Circuit Court of Appeals was the only appellate court to strike the individual mandate last year.

Last August, the Eleventh Circuit rejected the idea that Congress could justify the individual mandate under the Commerce Clause because everyone, eventually, needs healthcare. In a 207-page opinion, the appellate court wrote, "The government's position amounts to an argument that the mere fact of an individual's existence substantially affects interstate commerce, and therefore Congress may regulate them at every point of their life."

In today's 5-4 decision upholding the individual mandate, Chief Justice John Roberts similarly rejected that argument, writing, "Congress thought it could enact [the individual mandate] under the Commerce Clause, and the Government primarily defended the law on that basis. But ... the Commerce Clause does not give Congress that power."

But the Nine parted ways with the Eleventh Circuit on the overall viability of the Affordable Care's Act's most controversial component, finding that the individual mandate is really just a condition that triggers a tax on those who do not have health care.

In addition to the individual mandate, the Affordable Care Act expanded Medicaid and tied federal funding to that expansion of state programs. The law said that states who did not accept the Medicaid expansion would risk losing existing Medicaid funds, reports ABC News.

The Eleventh Circuit Court of Appeals concluded that the Affordable Care Act's Medicaid expansion was constitutional, noting, "Existing Supreme Court precedent does not establish that Congress's inducements are unconstitutionally coercive, especially when the federal government will bear nearly all the costs of the program's amplified enrollments."

The Supreme Court, however, narrowed the scope of the law, ruling that states which choose not to participate in the Medicaid expansion will not lose existing funds, they would only lose additional funding established under the Act.

Chief Justice Roberts wrote, "The Court today limits the financial pressure the Secretary may apply to induce States to accept the terms of the Medicaid expansion. As a practical matter, states may now choose to reject expansion; that is the whole point."

The question now, according to ProPublica, is which of the 26 states that challenged the Medicaid expansion will actually reject the expansion?

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