Florida et al v. Dept. Of Health & Human Services et al

FILEDU.S. COURT OF

APPEALSELEVENTH CIRCUITAUG 12, 2011JOHN LEYCLERK

[PUBLISH]IN THE UNITED STATES COURT OF APPEALSFOR THE ELEVENTH CIRCUIT________________________ Nos. 11-11021 & 11-11067________________________ D.C. Docket No. 3:10-cv-00091-RV-EMTSTATE OF FLORIDA, by and through Attorney General, STATE OF SOUTHCAROLINA, by and through Attorney General, STATE OF NEBRASKA, by andthrough Attorney General, STATE OF TEXAS, by and through Attorney General,STATE OF UTAH, by and through Attorney General, et. al.,Plaintiffs - Appellees - Cross-Appellants,versusUNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES,SECRETARY OF THE UNITED STATES DEPARTMENT OF HEALTH ANDHUMAN SERVICES, UNITED STATES DEPARTMENT OF THE TREASURY,SECRETARY OF THE UNITED STATES DEPARTMENT OF TREASURY,UNITED STATES DEPARTMENT OF LABOR, SECRETARY OF THEUNITED STATES DEPARTMENT OF LABOR,Defendants - Appellants - Cross-Appellees. ________________________ Appeals from the United States District Courtfor the Northern District of Florida________________________ (August 12, 2011)

Before DUBINA, Chief Judge, and HULL and MARCUS, Circuit Judges.DUBINA, Chief Judge, and HULL, Circuit Judge:

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Soon after Congress passed the Patient Protection and Affordable Care Act,Pub. L. No. 111-148, 124 Stat. 119 (2010),

amended by

Health Care andEducation Reconciliation Act of 2010 (“HCERA”), Pub. L. No. 111-152, 124 Stat.1029 (2010) (the “Act”), the plaintiffs brought this action challenging the Act’sconstitutionality. The plaintiffs are 26 states, private individuals Mary Brown andKaj Ahlburg, and the National Federation of Independent Business (“NFIB”)(collectively the “plaintiffs”). The defendants are the federal Health and Human

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Services (“HHS”), Treasury, and Labor Departments and their Secretaries(collectively the “government”).The district court granted summary judgment (1) to the government on thestate plaintiffs’ claim that the Act’s expansion of Medicaid is unconstitutional and(2) to the plaintiffs on their claim that the Act’s individual mandate—that

This opinion was written jointly by Judges Dubina and Hull.

Cf. Waters v. Thomas

,

46

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F.3d 1506, 1509 (11th Cir. 1995) (authored by Anderson and Carnes, J.J.) (citing

Peek v. Kemp

,784 F.2d 1479 (11th Cir.) (en banc) (authored by Vance and Anderson, J.J.),

cert. denied

, 479U.S. 939, 107 S. Ct. 421 (1986)).The 26 state plaintiffs are Alabama, Alaska, Arizona, Colorado, Florida, Georgia, Idaho,

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Indiana, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Nebraska, Nevada, NorthDakota, Ohio, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Washington,Wisconsin, and Wyoming.2

individuals purchase and continuously maintain health insurance from privatecompanies—is unconstitutional. The district court concluded that the individual

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mandate exceeded congressional authority under Article I of the Constitution because it was not enacted pursuant to Congress’s tax power and it exceededCongress’s power under the Commerce Clause and the Necessary and Proper Clause. The district court also concluded that the individual mandate provisionwas not severable from the rest of the Act and declared the entire Act invalid.The government appeals the district court’s ruling that the individualmandate is unconstitutional and its severability holding. The state plaintiffs cross-appeal the district court’s ruling on their Medicaid expansion claim. For thereasons that follow, we affirm in part and reverse in part.

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INTRODUCTION

Legal issues concerning the constitutionality of a legislative act presentimportant but difficult questions for the courts. Here, that importance and

As explained later, unless the person is covered by a government-funded health program,

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such as Medicare, Medicaid, and others, the mandate is to purchase insurance from a privateinsurer.We review the district court’s grant of summary judgment

de novo

.

Sammy’s of Mobile,

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Ltd. v. City of Mobile

, 140 F.3d 993, 995 (11th Cir. 1998). We review

de novo

a constitutionalchallenge to a statute.

United States v. Cunningham

, 607 F.3d 1264, 1266 (11th Cir.),

cert.denied

, 131 S. Ct. 482 (2010).3