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. 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]. 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. 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 Florida v. United States HHS , 648 F.3d 1235 (11 th Cir. Fla. 2011) http://www.uscourts.gov/uscourts/courts/ca11/201111021.pdf 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 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. 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 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. 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 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. 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. 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 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 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 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. 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 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 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 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. 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 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 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 The following are selected links to statutes, laws, and cases that are relevant to the issues before the Court. 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. 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). 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. 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. 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. 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. 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].

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.