Monday, August 15, 2011

Eleventh Circuit Strikes Down Individual Mandate

In ruling that the individual mandate in the Patient Protection and Affordable Care Act (ACA) is unconstitutional, the Eleventh Circuit U.S. Court of Appeals has set the stage for a final resolution of the the status of the health reform act in the Supreme Court.

The Eleventh Circuit’s 2-1 decision (State of Florida v. Department of Health and Human Services, Nos. 11-11021 & 11-11067) included three conclusions:

The ACA’s Medicaid expansion is constitutional.

  1. “The individual mandate was enacted as a regulatory penalty, not a revenue-raising tax, and cannot be sustained as an exercise of Congress’s power under the Taxing and Spending Clause.… Further, the individual mandate exceeds Congress’s enumerated commerce power and is unconstitutional.”

  2. The individual mandate, however, can be severed from the remainder of the [ACA’s] myriad reforms….The [ACA’s] other provisions remain legally operative after the mandate’s excision.”

Thus, the Eleventh Circuit affirmed in part the lower court decision that the individual mandate is unconstitutional, but reversed the ruling that the individual mandate could not be severed from the rest of the law and thus the whole law was unconstitutional.

The ruling, if upheld, would invalidate IRC Sec. 5000A, as added by the ACA. Sec. 5000A mandates that after 2013, individuals must maintain “minimum essential coverage” for themselves and their dependents, or pay a monetary penalty.

The Eleventh Circuit opinion is directly at odd with the ruling of the Sixth Circuit U.S. Court of Appeals, which ruled that the individual mandate stated that “is a valid exercise of Congress’s authority under the Constitution’s Commerce Clause.” This conflict allows the Supreme Court to take up the issue in order to resolve the differences in the appellate courts.

The Sixth Circuit’s ruling already has been appealed to the Supreme Court
. One other appellate court also has ruled on the ACA.

For more information on the Eleventh Circuit’s opinion, visit

For a comprehensive analysis of the ACA, and additional information on health reform and other developments in employee benefits, just click here.


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