National Federation of Independent Business v. Sebelius: Affordable Care Act Litigation Resources
Released: 2012-08-09T00:00:00

Summary:
In March 2010, Congress passed P.L. 111-148, the Patient Protection and Affordable Care Act of 2010 (PPACA), and amended it by passing P.L. 111-152, the Health Care and Education Reconciliation Act of 2010 (HCERA). Subsequently, lawsuits were filed in multiple courts challenging various aspects of the new law. Many of these cases were heard in the district courts and a few were appealed to appellate courts. In November 2011, the Supreme Court granted three petitions for certiorari in one of these cases. On June 28, 2012, the Court issued its decision in the case, National Federation of Independent Business et al. v. Sebelius.
This report contains resources for retrieving background information and selected legal material relevant to these cases. It also includes information on CRS experts and products to assist in understanding the legal and policy issues related to the act. This report will be updated as needed.

paragraphs: In March 2010, Congress passed P.L. 111-148 , the Patient Protection and Affordable Care Act of 2010 (PPACA) and amended it by passing P.L. 111-152 , the Health Care and Education Reconciliation Act of 2010 (HCERA). Subsequently, lawsuits were filed in multiple courts challenging various aspects of the new law. Many of these cases made their way through the judicial system and three petitions for certiorari were ultimately granted by the United States Supreme Court in one of these cases. The Court ultimately decided in favor of the law in June 2012. This collection of resources is intended to assist in responding to a broad range of research questions and requests for assistance related to the Affordable Care Act litigation before the Supreme Court.
subsections: section_title: Supreme Court Cases
paragraphs: On November 14, 2011, the Supreme Court granted three petitions for certiorari to decide issues raised by the Affordable Care Act cases: (1) National Federation of Independent Business v. Sebelius , No. 11-393; (2) Florida v Department of Human Services , No. 11-400; and (3) Department of Health and Human Services v. Florida , No. 11-398. Please note, the Court agreed to hear four separate questions raised by the three petitions. Oral arguments for the cases took place March 26-28, 2012. On June 28, 2012, the Court issued its decision in the case, National Federation of Independent Business et al. v. Sebelius.
Below are links to documents related to these cases before the Court. Many of the documents are available on the Supreme Court's Patient Protection and Affordable Care Act website at http://www.supremecourt.gov/docket/PPAACA.aspx . For further information from the Court, the public information officer can be reached at [phone number scrubbed].
subsections: section_title: Department of Health and Human Services et al. v. Florida et al.
paragraphs: The questions for the Court raised by this petition are whether Congress has the power under Article I of the Constitution to enact the minimum coverage provision of PPACA and whether the challenges to the minimum coverage provision itself are barred by the Anti-Injunction Act.
subsections: section_title: Supreme Court
paragraphs: Docket No. 11-398 http://www.supremecourt.gov/Search.aspx?FileName=/docketfiles/11-398.htm Petition for a Writ of Certiorari http://www.supremecourt.gov/docket/PDFs/11-398%20Cert%20Petititon.pdf Appendix to Petition http://www.supremecourt.gov/docket/PDFs/11-398%20appendix.pdf Brief of Private Respondents http://www.supremecourt.gov/docket/PDFs/11-398%20BIO%20Private.pdf Brief of State Respondents http://www.supremecourt.gov/docket/PDFs/11-398%20BIO%20States.pdf Reply Brief http://www.supremecourt.gov/docket/PDFs/11-398%20Reply.pdfAmicus Briefs (as compiled by the American Bar Association ) Anti-Injunction Ac t— http://www.americanbar.org/publications/preview_home/11-398_Anti-InjuntionAct.html Minimum Coverage Provisio n— http://www.americanbar.org/publications/preview_home/11-398.htmlTranscript of Oral Arguments March 26, 2012 — http://www.supremecourt.gov/oral_arguments/argument_transcripts/11-398-Monday.pdf March 27, 2012— http://www.supremecourt.gov/oral_arguments/argument_transcripts/11-398-Tuesday.pdfSlip Opinion http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf 
section_title: Appeals Court (United States Court of Appeals for the Eleventh Circuit)
paragraphs: Florida v. United States HHS , 648 F.3d 1235 (11 th Cir. Fla. 2011) http://www.uscourts.gov/uscourts/courts/ca11/201111021.pdf
section_title: District Court (Northern District of Florida)
paragraphs: Order Granting Summary Judgment, Florida v. United States HHS , 780 F. Supp. 2d 1256 (N.D. Fla. 2011) http://www.justice.gov/healthcare/docs/fl-sj-ruling.pdf
section_title: National Federation of Independent Business et. al. v. Kathleen Sebelius et al.
paragraphs: The questions for the Court in this petition concern the severability of the minimum coverage provision from the rest of the Affordable Care Act if the minimum coverage provision is found to be unconstitutional.
subsections: section_title: Supreme Court
paragraphs: Docket No. 393 http://www.supremecourt.gov/Search.aspx?FileName=/docketfiles/11-393.htm Petition for Writ of Certiorari http://www.supremecourt.gov/docket/PDFs/11-393%20Cert%20Petition.pdf Appendix to Petition http://www.supremecourt.gov/docket/PDFs/11-393%20Appendix.pdf Brief in Opposition http://www.supremecourt.gov/docket/PDFs/11-393%20BIO.pdfAmicus Briefs (as compiled by the American Bar Association) Severability — http://www.americanbar.org/publications/preview_home/11-393.htmlTranscript of Oral Arguments March 28, 2012 — http://www.supremecourt.gov/oral_arguments/argument_transcripts/11-393.pdfSlip Opinion http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf
section_title: Florida et al. v. Department of Health and Human Services et al.
paragraphs: The questions for the Court in this petition are limited to whether the individual mandate can be severed from the act, and whether the changes to Medicaid in the Affordable Care Act unconstitutionally coerce the states.
subsections: section_title: Supreme Court
paragraphs: Docket No. 11-400 http://www.supremecourt.gov/Search.aspx?FileName=/docketfiles/11-400.htm Petition for Writ of Certiorari http://www.supremecourt.gov/docket/PDFs/11-400%20Cert%20Petition.pdf Brief in Opposition http://www.supremecourt.gov/docket/PDFs/11-400%20BIO.pdf Reply Brief http://www.supremecourt.gov/docket/PDFs/11-400%20Reply.pdfAmicus Briefs (as compiled by the American Bar Association) Severability — http://www.americanbar.org/publications/preview_home/11-393.html Medicaid — http://www.americanbar.org/publications/preview_home/11-400_Medicaid.htmlTranscript of Oral Arguments March 28, 2012 — http://www.supremecourt.gov/oral_arguments/argument_transcripts/11-400.pdfSlip Opinion http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf
section_title: Other Supreme Court Petitions
paragraphs: In addition to the cases referenced above, information is provided on three other cases in which a petition for a writ of certiorari has been filed and that contain notable legal arguments related to the Affordable Care Act cases. 
subsections: section_title: Thomas More Law Center et al. v. Barack H. Obama et al.
paragraphs: In this petition for certiorari, the petitioners present arguments on whether Congress had the power under Article I of the Constitution to enact the minimum coverage provision of PPACA.
subsections: section_title: Supreme Court
paragraphs: Docket No. 11-117 http://www.supremecourt.gov/Search.aspx?FileName=/docketfiles/11-117.htm Petition for Writ of Certiorari http://www.supremecourt.gov/docket/PDFs/11-117%20Cert%20Petition.pdf Brief in Opposition http://www.supremecourt.gov/docket/PDFs/11-117%20BIO.pdf Reply Brief http://www.supremecourt.gov/docket/PDFs/11-117%20%20Reply.pdf
section_title: Appeals Court (United States Court of Appeals for the Sixth Circuit)
paragraphs: Opinion, Thomas More Law Ctr. v. Obama , 651 F.3d 529 (6 th Cir. Mich. 2011) http://www.ca6.uscourts.gov/opinions.pdf/11a0168p-06.pdf
section_title: District Court (Eastern District of Michigan)
paragraphs: Order Denying Plaintiffs' Motion for Injunction and Dismissing Plaintiffs' First and Second Claims for Relief [Doc #7], Thomas More Law Ctr. v. Obama , 720 F. Supp. 2d 882 (E.D. Mich. 2010) http://www.mied.uscourts.gov/News/Docs/09714485866.pdf
section_title: Virginia, ex rel. Kenneth T. Cuccinelli, II, v. Sebelius
paragraphs: In this petition for certiorari, the petitioners present arguments on whether a state has standing to challenge the minimum coverage provision, whether Congress had the power under Article I of the Constitution to enact the minimum coverage provision, and whether the minimum coverage provision is severable from the rest of the Affordable Care Act.
subsections: section_title: Supreme Court
paragraphs: Docket No. 11-420 http://www.supremecourt.gov/Search.aspx?FileName=/docketfiles/11-420.htm Petition for Writ of Certiorari http://www.supremecourt.gov/docket/PDFs/11-420%20Cert%20Petition.pdf Brief in Opposition http://www.supremecourt.gov/docket/PDFs/11-420%20BIO.pdf
section_title: Appeals Court (United States Court of Appeals for the Fourth Circuit)
paragraphs: Opinion, Virginia ex rel. Cuccinelli v. Sebelius , 656 F.3d 253 (4 th Cir. Va. 2011) http://pacer.ca4.uscourts.gov/opinion.pdf/111057.P.pdf
section_title: District Court (Eastern District of Virginia)
paragraphs: Memorandum Opinion (Cross Motions for Summary Judgment), Commonwealth ex rel. Cuccinelli v. Sebelius , 728 F. Supp. 2d 768 (E.D. Va. 2010) http://www.justice.gov/healthcare/docs/cucinelli-v-sebelius-memo-opinion-summary-judgment.pdf
section_title: Liberty University et al. v. Timothy F. Geithner et al.
paragraphs: In this petition for certiorari, the petitioners present arguments on whether the challenges to the minimum coverage provision itself are barred by the Anti-Injunction Act and whether Congress has the power under Article I of the Constitution to enact the minimum coverage provision of PPACA.
subsections: section_title: Supreme Court
paragraphs: Docket No. 11-438 http://www.supremecourt.gov/Search.aspx?FileName=/docketfiles/11-438.htm Petition for a Writ of Certiorari http://www.supremecourt.gov/docket/PDFs/11-438%20Cert%20Petition.pdf Brief in Opposition http://www.supremecourt.gov/docket/PDFs/11-438%20BIO.pdf Reply Brief http://www.supremecourt.gov/docket/PDFs/11-438%20Reply.pdf
section_title: Appeals Court (United States Court of Appeals for the Fourth Circuit)
paragraphs: Opinion , Liberty Univ., Inc. v. Geithner , 2011 U.S. App. LEXIS 18618, 2011 WL 3962915 (4 th Cir. Va. 2011) http://www.justice.gov/healthcare/docs/liberty-university-4th-circuit-opinion.pdf
section_title: District Court (Western District of Virginia)
paragraphs: Memorandum Opinion, Liberty Univ., Inc. v. Geithner , 753 F. Supp. 2d 611 (W.D. Va. 2010) http://www.vawd.uscourts.gov/OPINIONS/MOON/LIBERTYUNIVERSITYVGEITHNER.PDF
section_title: Selected Federal Legal Resources
paragraphs: The following are selected links to statutes, laws, and cases that are relevant to the issues before the Court.
subsections: section_title: Constitution of the United States
paragraphs: The Constitution of the United States of America: Analysis and Interpretation http://crs.gov/analysis/Pages/constitutionannotated.aspx?source=QuickLinks
Also known as "The Constitution Annotated" or "CONAN", this resource contains legal analysis and interpretation of the United States Constitution, based primarily on Supreme Court case law. It is especially useful when researching the constitutional implications of a specific issue or topic. Some of the commonly referenced constitutional provisions related to PPACA are below:
Constitution of the United States, Article I, Section 8, Clause 1. The "Power to Tax and Spend Clause" The Congress shall have Power to lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States.
Constitution of the United States, Article I, Section 8, Clause 3. The "Commerce Clause" The Congress shall have Power *** To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes.
Constitution of the United States, Article I, Section 8, Clause 18. The "Necessary and Proper Clause" The Congress shall have Power *** To make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers, and all other Powers vested by the Constitution in the Government of the United States, or in any Department or Officer thereof.
Constitution of the United States, Article VI, Clause 2 . The " Supremacy Clause " This Constitution, and the Laws of the United States which shall be made in Pursuance thereof; and all Treaties made, or which shall be made, under the Authority of the United States, shall be the supreme Law of the Land; and the Judges in every State shall be bound thereby; any Thing in the Constitution or Laws of any State to the Contrary notwithstanding.
section_title: Statutes and U.S. Code
paragraphs: Compilation of the Patient Protection and Affordable Care Act http://housedocs.house.gov/energycommerce/ppacacon.pdf
Compiled by the Office of Legislative Counsel, this committee print contains the text of P.L. 111-148 , the Patient Protection and Affordable Care Act (PPACA) consolidated with the amendments made by title X of P.L. 111-152 , the Health Care and Education Reconciliation Act of 2010 (HCERA). Links to the text of the codified version of two particular PPACA provisions at issue in the litigation are provided below:
Maintenance of Minimum Essential Coverage , 26 U.S.C. §5000A. http://www.gpo.gov/fdsys/pkg/USCODE-2010-title26/pdf/USCODE-2010-title26-subtitleD-chap48.pdf
Enacted and amended as part of the health care reform legislation, this section of PPACA deals with minimum coverage.
State Plans for Medical Assistance , 42 U.S.C. §1396a http://www.gpo.gov/fdsys/pkg/USCODE-2010-title42/pdf/USCODE-2010-title42-chap7-subchapXIX-sec1396a.pdf
PPACA amended existing laws related to the Medicaid program to require expanded coverage.
Anti-Injunction Act , 26 U.S.C. §7421 http://www.gpo.gov/fdsys/pkg/USCODE-2010-title26/pdf/USCODE-2010-title26-subtitleF-chap76-subchapB-sec7421.pdf
Enacted in 1954, this act prohibits a court from hearing a case to prevent the assessment or collection of a tax (except in certain circumstances).
section_title: Cases and Litigation
paragraphs: Below are three cases often cited in the discussion of commerce clause issues.
United States v. Lopez , 514 U.S. 549 (U.S. 1995) http://www.supremecourt.gov/opinions/boundvolumes/514bv.pdf
In this Supreme Court case, a conviction under the Guns Free School Zone Act was overturned. The Court held the act was beyond the power of Congress under the commerce clause.
United States v. Morrison , 529 U.S. 598 (U.S. 2000) http://www.supremecourt.gov/opinions/boundvolumes/529bv.pdf
In this case, the Court held Congress lacked the authority to enact a statute because it did not involve commercial activity.
Gonzalez v. Raich , 545 U.S. 1 (U.S. 2005) http://www.supremecourt.gov/opinions/boundvolumes/545bv.pdf
The Court examined whether Congress could prohibit the cultivation of marijuana for personal, medicinal use, and held that such regulation was permissible under the Commerce Clause because these activities, when viewed in the aggregate, had a substantial effect on the interstate market for marijuana.
Below are two cases cited in the discussion of the expansion of Medicaid coverage.
South Dakota v. Dole , 483 U.S. 203 (U.S. 1987) http://www.law.cornell.edu/supremecourt/text/483/203
In this case, the Court held that the general welfare provision of the Taxing and Spending Clause to the Constitution gave Congress the power to condition federal funds on a state's establishment of a minimum drinking age.
Garcia v. San Antonio Metro. Transit Auth ., 469 U.S. 528 (U.S. 1985) http://www.law.cornell.edu/supremecourt/text/469/528
In this case, the Court held that a public mass transit authority entity was not entitled to immunity from federal wage and overtime standards.
section_title: Glossary of Common Litigation Terms
paragraphs: In researching these cases, those less accustomed with court proceedings may encounter unfamiliar terms. Below are definitions, taken from Black's Law Dictionary, Ninth Edition , for some common words used in litigation.
section_title: Selected CRS Products
paragraphs: Listed below are existing CRS products on the Affordable Care Act litigation and related policy issues. Additional titles are available on the CRS.gov website, http://www.crs.gov , by searching or browsing the Health Care Issues Before Congress.
subsections: section_title: Affordable Care Act Litigation
paragraphs: CRS Report R40725, Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis , by Jennifer Staman et al.
CRS Report R40846, Health Care: Constitutional Rights and Legislative Powers , by [author name scrubbed].
CRS Report R42367, Medicaid and Federal Grant Conditions After NFIB v. Sebelius: Constitutional Issues and Analysis , by [author name scrubbed].
CRS Report RL34708, Religious Exemptions for Mandatory Health Care Programs: A Legal Analysis , by Cynthia Brougher.
section_title: Affordable Care Act Policy Issues
paragraphs: CRS Report R41664, ACA: A Brief Overview of the Law, Implementation, and Legal Challenges , coordinated by [author name scrubbed].
CRS Report R41331, Individual Mandate and Related Information Requirements under ACA , by [author name scrubbed] and [author name scrubbed].
CRS Report R41159, Summary of Potential Employer Penalties Under the Patient Protection and Affordable Care Act (PPACA) , by [author name scrubbed].
CRS Report R41210, Medicaid and the State Children's Health Insurance Program (CHIP) Provisions in ACA: Summary and Timeline , by [author name scrubbed] et al.
CRS Report R42431, Upcoming Rules Pursuant to the Patient Protection and Affordable Care Act: Fall 2011 Unified Agenda , by [author name scrubbed] and [author name scrubbed].