Cleveland State University College of Law.
J Law Health. 2024;37(3):387-410.
The Affordable Care Act ("ACA") contains a section titled "Requirement to Maintain Essential Minimum Coverage." Colloquially known as the Individual Mandate, this section of the Act initially established a monetary penalty for anyone who did not maintain health insurance in a given tax year. But with the passage of the Tax Cuts and Jobs Act, the monetary penalty was reset to zero, inducing opponents of the ACA to mount a legal challenge over the Individual Mandate's constitutionality. As the third major legal challenge to the ACA, California v. Texas saw the Supreme Court punt on the merits and instead decide the case on grounds of Article III standing. But how would the ACA have fared if the Court had in fact reached the merits? Did resetting the Individual Mandate penalty to zero uncloak the provision from the saving construction of Nat'l Fed'n of Indep. Bus. v. Sebelius? This Note posits that, had the Court reached the merits, it would have found the Individual Mandate no longer met the requirements for classification as a tax under the rule relied on in NFIB. Moreover, it argues that the Court would have found the unconstitutional provision to be inseverable from the ACA insofar as it was integral to funding both the novel structure of the reformed healthcare system and the prohibition against insurance carriers denying coverage due to a pre-existing condition. This examination ultimately reveals that an outright repeal of the ACA would have been antidemocratic in the face of current consensus opinion that favors the reform and highlights the impact its abrogation would have had.
平价医疗法案（“ACA”）包含一个名为“维持基本最低覆盖要求”的章节。通俗地称为个人强制保险，该法案的这一部分最初对任何在特定纳税年度未维持医疗保险的人设定了货币罚款。但随着《减税和就业法案》的通过，罚款金额已重置为零，这促使 ACA 的反对者对个人强制保险的合宪性提出法律挑战。作为对 ACA 的第三次重大法律挑战，加利福尼亚诉德克萨斯州案使最高法院避开了案情实质，而是根据第三条规定的诉讼资格决定了此案。但是，如果法院实际上审理了案情实质，ACA 会有怎样的结果？将个人强制保险罚款金额重置为零是否使该条款摆脱了 National Fed'n of Indep. Bus. v. Sebelius 案中节省的构建？本说明假设，如果法院审理了案情实质，它将发现个人强制保险不再符合 NFIB 所依据的规则下归类为税收的要求。此外，它认为，由于该条款是改革后医疗保健系统的新颖结构和禁止保险公司因先前存在的条件而拒绝承保的资金的组成部分，因此违宪条款是不可分割的。这种审查最终表明，面对当前支持改革的主流意见，彻底废除 ACA 将是反民主的，并强调了废除该法案将产生的影响。
