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IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF TEXAS FORT WORTH DIVISION TEXAS, et al., Plaintiffs, v. UNITED STATES OF AMERICA, et al., Defendants, CALIFORNIA, et al. Intervenors-Defendants. § § § § § § § § §§§ §§§ Civil Action No. 4:18-cv-00167-O MEMORANDUM OPINION AND ORDER

The United States healthcare system touches millions of lives in a daily and deeply personal way. Health-insurance policy is therefore a politically charged affair

—

inflaming emotions and testing civility. But Article III courts, the Supreme Court has confirmed, are not tasked with, nor are they suited to, policymaking.

1

Instead, courts resolve discrete cases and controversies. And sometimes, a court must determine whether the Constitution grants Congress the power it asserts and what results if it does not. If a party shows that a policymaker exceeded the authority granted it by the Constitution, the fruit of that unauthorized action cannot stand. Here, the Plaintiffs allege that, following passage of the Tax Cuts and Jobs Act of 2017 (TCJA), the Individual Mandate in the Patient Protection and Affordable Care Act (ACA) is unconstitutional. They say it is no longer fairly readable

as an exercise of Congress’s Tax Power

1

See

Nat’l Fed’n of Indep. Businesses v. Sebelius (NFIB)

, 567 U.S. 519, 530

–

38 (2012) (noting the wisdom

of legislative policy is entrusted to the Nation’s elected leaders).

Case 4:18-cv-00167-O Document 211 Filed 12/14/18 Page 1 of 55 PageID 2557

2 and continues to be unsustainable under the Interstate Commerce Clause. They further urge that, if they are correct, the balance of the ACA is untenable as inseverable from the Invalid Mandate. Resolution of these claims rests at

the intersection of the ACA, the Supreme Court’s

decision in

NFIB

, and the TCJA. In

NFIB

, the Supreme Court held the Individual Mandate was unconstitutional under the Interstate Commerce Clause but could fairly be read as an exercise of Congr

ess’s Tax Power because it triggered a tax. The TCJA eliminated that tax. The Supreme Court’s reasoning in

NFIB

—

buttressed by other binding precedent and plain text

—

thus compels the conclusion that the Individual Mandate may no longer be upheld under the Tax Power. And because the Individual Mandate continues to mandate the purchase of health insurance, it remains unsustainable under the Interstate Commerce Clause

—

as the Supreme Court already held. Finally, Congress stated many times unequivocally

—

through enacted text signed by the President

—that the Individual Mandate is “essential” to the ACA

. And this essentiality

, the ACA’s

text makes clear, means the mandate must work

“together with the other provisions”

for the Act to function as intended. All nine Justices to review the ACA

acknowledged this text and Congress’s manifest intent to establish the Individual Mandate as the ACA’s “essential” provision.

The current and previous Administrations have recognized that, too. Because rewriting the ACA without its

“essential” feature is beyond the power of an Article III court, t

he Court thus

adheres to Congress’s

textually expressed intent and binding Supreme Court precedent to find the Individual Mandate is

inseverable from the ACA’s

remaining provisions. Construing the

Plaintiffs’

Application for Preliminary Injunction, (ECF No. 39), as a motion for partial summary judgment, the Court therefore

DENIES

Plaintiffs’ request for an

injunction but

GRANTS

summary judgment on Count I of the Amended Complaint.

See

F

ED

.

R.

C

IV

.

P. 56(f); July 16, 2018 Order, ECF No. 176.


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I.

BACKGROUND

More than any factual developments, the background to this case involves the nuances of the ACA,

NFIB

, and the TCJA, which the Court traces below.

A.

The ACA

The ACA became law on March 23, 2010.

See

Patient Protection and Affordable Care Act, Pub. L. 111-148, 124 Stat. 119-1045 (2010). Congress intended the ACA to

achieve “near

-

universal” health

-insurance coverage and to

“lower health insurance premiums”

through the

“creation of effective health insurance markets” and new statutory requirements for

individuals and insurance companies.

See, e.g.

, 42 U.S.C. §§ 18091(2)(D), (2)(F), and (2)(I). It pursued these goals through a carefully balanced restructuring

of the Nation’s health

-insurance ecosystem. For starters, the ACA

established a “[r]equirement to

maintain minimum essential

coverage”—

commonly known

as the “

Individual M

andate.”

26 U.S.C. § 5000A(a). To compel compliance with the Individual Mandate, Congress imposed a tax penalty on individuals who were subject to the requirement but chose to disobey it.

Id.

§ 5000A(b). The ACA labeled this penalty

the “[s]

hared responsibility payment.

”

It was originally to be assessed at either $695.00 or a 2.5 perce

nt share of a family’s househ

old income

—

whichever was greater.

Id.

§ 5000A(c). From the start, Congress exempted some individuals from Individual Mandate. For

example: those qualifying for a “[r]eligious exemption[],”

id.

§

5000A(d)(2)(A); “member[s] of a health care sharing ministry,”

id.

§ 5000(d)(2)(B); individuals who are “not . . . citizen[s] or national[s] of the United States . . . or alien[s] lawfully present in the United States,”

id.

§

5000A(d)(3); and “[i]ncarcerated individuals,”

id.

§ 5000A(d)(4). At the same time, Congress exempted five categories of individuals from the shared-responsibility payment but not the Individual Mandate.

See id.

§ 5000A(e). This means several classes of individuals are obligated
