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U.S. Court of Appeals, Eleventh Circuit: Health Care Law Ruling

U.S. Court of Appeals, Eleventh Circuit: Health Care Law Ruling

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Published by: Nick Ehrenberg on Aug 12, 2011
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[PUBLISH]IN THE UNITED STATES COURT OF APPEALS FOR 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 Court for 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:
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
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
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,
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
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.
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,
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,
 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.),
, 131 S. Ct. 482 (2010).3

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