The Supreme Court ruled the Affordable Care Act (ACA) constitutional in June. But Jerry Falwell’s Liberty University is still trying to drive a stake through its heart.
Supremes Reconsidering Obamacare?
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Joyce Frieden of MedPage Today reports on October 1 that the Supreme Court, now in a new term, has given the Obama administration and Liberty University 30 days to file responses in a case previously dismissed by the Fourth Circuit Court of Appeals and refused to be heard by the Court after ruling the law constitutional.
Just in time for Halloween.
Liberty University and two women assert that the penalty under the mandate is really a tax and Congress can only impose taxes on actual purchases. They argue that the Supreme Court’s upholding of the ACA did not address that specific question and want another chance to make their case.
The two women also contend that the individual mandate exceeds Congress’s authority under the Commerce Clause of the Constitution. This, according to Frieden, is the position that the Supreme Court also took when it said that the ACA’s individual mandate was not constitutional under the Commerce Clause but was constitutional under Congress’ power to levy a tax.
The plaintiffs all are asking that the ACA not be enforced and that the Court declare it unconstitutional. The U.S. District Court for the Western District of Virginia dismissed the case in November 2010, ruling that the ACA is valid under the Commerce Clause.
“The plaintiffs, ” wrote Frieden, “then appealed the case to the U.S. Court of Appeals for the Fourth Circuit, which also dismissed the case in September 2011 but for a different reason—it said that under the Anti-Injunction Act (AIA), which says that a person cannot file suit over a particular tax until that tax has actually been levied, the suit was premature and couldn’t be filed yet. (The Supreme Court rejected a similar AIA argument when it decided its case in June.)”
The plaintiffs have now asked the Supreme Court to reconsider its previous decision not to hear their case.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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