Title: Affordable Care Act cases | law cases | Britannica
Headings: Affordable Care Act cases
Affordable Care Act cases
law cases
District and appellate decisions

Content: District and appellate decisions
The Affordable Care Act cases originated in a suit filed in U.S. District Court for the Northern District of Florida. In State of Florida et al. v. United States Department of Health and Human Services et al., Florida and 12 other states (later joined by 13 additional states, two individuals, and the National Federation of Independent Business [NFIB]) argued that in passing the individual mandate Congress had exceeded its power under the commerce clause to regulate interstate commerce, because the mandate amounted to a regulation of “inactivity”—i.e., the failure to purchase health insurance. The state plaintiffs additionally alleged that the PPACA’s expansion of Medicaid was an onerous financial burden that they had been forced to accept to continue receiving federal matching funds for Medicaid beneficiaries within their borders. Although state participation in Medicaid is voluntary, the plaintiffs could not realistically opt out of the program, which had become “customary and necessary for citizens throughout the United States, including the Plaintiffs’ respective states.” The Medicaid expansion thus allegedly violated the spending clause of the U.S. Constitution (Article I, Section 8, Clause 1), which does not permit Congress to offer financial inducements to the states that are “so coercive as to pass the point at which pressure turns into compulsion,” as the Supreme Court ruled in South Dakota v. Dole (1987), citing the court’s decision in Steward Machine Co. v. Davis (1937). In his ruling, issued in January 2011, U.S. District Court Judge Roger Vinson agreed with the government that the plaintiffs’ underlying “coercion theory” was unsupported in existing case law, having been rejected in challenges to federal spending laws by “every single federal Court of Appeals.” On the constitutionality of the individual mandate, however, he agreed with the plaintiffs that the commerce clause limits the scope of Congress’s regulatory authority to “activities”;