Possible unintended consequences of the U.S. Supreme Court’s ‘Obamacare’ ruling

12 Jul

Mark Walsh has an intriguing Education Week about the aftermath of the U.S. Supreme Court’s “Obamacare” decision and its possible impact on education. In Ed. Law Challenges Loom After Health-Care Ruling, Walsh writes:

Legal analysts say that part of the U.S. Supreme Court decision on the federal health-care law will encourage states to challenge education laws and other federal aid programs and legislation passed under Congress’ spending power, a pivotal aspect of the historic ruling.

The justices ruled 5-4 to uphold a key provision of the Affordable Care Act—the requirement that individuals purchase a health-insurance policy with at least a minimum level of coverage—as a valid exercise under Congress’ taxing power. But the court effectively ruled 7-2 that the states could not be threatened with the loss of their existing Medicaid funding if they refused to participate in the law’s expansion of the federal health-care program for the poor.

That portion of the June 28 decision in National Federation of Independent Business v. SebeliusRequires Adobe Acrobat Reader (Case No. 11-393) could open the door to lawsuits over the spending strings attached to federal programs—or even the conditions for securing federal waivers under the No Child Left Behind Act, some commentators say….

Mr. Bagenstos of the University of Michigan noted that some federal education laws, such as the ESEA, have relatively frequent reauthorizations and revisions, leading to uncertainty about when conditions are first imposed. And other federal laws that come with conditions on the states, such as Title IX, are not grant programs per se but anti-discrimination statutes.

The rules aren’t tied to any particular funds” under such statutes, he said.

Mr. Bagenstos does not believe that the state challenges he predicts ultimately will be successful. But the Medicaid ruling could alter the dynamics of state-federal relations over such things as federal waivers for the No Child Left Behind Act, he said.

A state could say, ‘Look, if our waiver gets denied, we’re going to court,’ ” Mr. Bagenstos said.

Do I think these arguments are going to be successful in the courts? Ultimately, no,” he added. “But these are arguments that are going to take a while to work their way through the courts.”http://www.edweek.org/ew/articles/2012/07/12/36scotus.h31.html?tkn=PPTFLaYDB9dQxlfFlrIbQ3taERAkJIQPVmNa&intc=es

The possible reason for concern about education law suits is the portion of the Supreme Court’s majority opinion which deals with the possible coercive aspects of Medicaid expansion.

Health Reform GPS has an excellent summary of the case in Summary of the U.S. Supreme Court decision in the case of National Federation of Independent Businesses et al. v. Sebelius, Secretary of Health and Human Services, et al.. Here is the portion of the case Walsh writes about:

The Constitution simply does not give Congress the authority to require the States to regulate. That is true whether Congress directly commands a State to regulate or indirectly coerces a State to adopt a federal regulatory system as its own.” Majority, p. 47-48. “When, for example, such conditions take the form of threats to terminate other significant independent grants, the conditions are properly viewed as a means of pressuring the States to accept policy changes.” Majority, p. 50. Furthermore, the Medicaid expansion “accomplishes a shift in kind, not merely degree. The original program was designed to cover medical services for four particular categories of the needy: the disabled, the blind, the elderly, and needy families with dependent children. Under the Affordable Care Act, Medicaid is transformed into a program to meet the health care needs of the entire nonelderly population with income below 133 percent of the poverty level. It is no longer a program to care for the neediest among us, but rather an element of a comprehensive national plan to provide universal health insurance coverage.” Majority, p. 53-54. However, “nothing in our opinion precludes Congress from offering funds under the Affordable Care Act to expand the availability of health care, and requiring that States accepting such funds comply with the conditions on their use. What Congress is not free to do is to penalize States that choose not to participate in that new program by taking away their existing Medicaid funding.” Majority, p. 55. http://healthreformgps.org/resources/summary-of-the-u-s-supreme-court-decision-in-the-case-of-national-federation-of-independent-businesses-et-al-v-sebelius-secretary-of-health-and-human-services-et-al/

It is important to understand the U.S. Legal system in order to understand why there might be unintended consequences from the court’s decision.

Mark F. Radcliffe and Diane Brinson of DLA Piper LLP (US) have written an excellent Findlaw article, The U.S. Legal System. The portion about the U.S. Supreme Court explains the role of precedent.

Supreme Court Review

There are two ways to get a case reviewed by the U.S. Supreme Court: by appeal and by certiorari . The losers in certain types of cases – for example, cases involving claims that state statutes are unconstitutional – have a right to appeal to the Supreme Court.

For most cases, though, there is no right of appeal to the Supreme Court. However, a party who has lost a case at the federal Court of Appeals level can file a petition for certiorari with the Supreme Court. A petition for certiorari is a document explaining why the Supreme Court should review a case. If the Supreme Court grants certiorari , the appeal proceeds. If the Court denies it, the Court of Appeals’ decision stands.

Thousands of petitions for certiorari are filed each year and most are denied. The Supreme Court is likely to grant certiorari on a case only if the case involves a matter of national interest or the Court believes that it must decide the case to resolve conflicts among the Circuit Courts and create uniformity in federal law.


An appellate court’s decision on an issue is binding on lower courts in the appellate court’s jurisdiction. Thus, an appellate court’s decisions are “precedent” that the lower courts in the appellate court’s jurisdiction must follow (apply).

Example: In Effects Associates, Inc. v. Cohen , the United States Court of Appeals for the Ninth Circuit held that the grant of a nonexclusive copyright license can be implied from the copyright owner’s conduct. This decision is binding on the federal district courts located in the Ninth Circuit. Those courts are not free to decide that a nonexclusive copyright license cannot be implied from conduct.

A lower court’s decision is not binding on a higher court. In fact, appellate courts frequently reverse decisions made by trial courts to correct the trial courts’ “mistakes of law.”

Because the United States Supreme Court is the “highest court in the land,” the Supreme Court’s decisions are binding on all courts in the United States. http://library.findlaw.com/1999/Jan/1/241487.html

The litigation may just be beginning.


Online symposium: The Bar Review version of NFIB v. Sebelius http://www.scotusblog.com/2012/07/online-symposium-the-bar-review-version-of-nfib-v-sebelius/

The Roberts Court and the Role of Precedent                               http://www.npr.org/templates/story/story.php?storyId=11688820

The Nature and Timing of the U.S. Supreme Court’s Interpretation of Precedent                                                                            http://www.bsos.umd.edu/gvpt/CITE-IT/Documents/Hansford%20etal%202002%20Nature%20and%20Timing%20of%20t%20US%20Supreme%20Court.pdf

Dr. Wilda says this about that ©

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