Justia Opinion Summary and Annotations

The 2010 Patient Protection and Affordable Care Act required most Americans to obtain minimum essential health insurance coverage and imposed a monetary penalty upon most individuals who failed to do so; 2017 amendments effectively nullified the penalty. Several states and two individuals sued, claiming that without the penalty, the Act’s minimum essential coverage provision, 26 U.S.C. 5000A(a), is unconstitutional and that the rest of the Act is not severable from section 5000A(a).

The Supreme Court held that the plaintiffs lack standing to challenge section 5000A(a) because they have not shown a past or future injury fairly traceable to the defendants’ conduct enforcing that statutory provision.

The individual plaintiffs cited past and future payments necessary to carry the minimum essential coverage; that injury is not “fairly traceable” to any “allegedly unlawful conduct” of which they complain, Without a penalty for noncompliance, section 5000A(a) is unenforceable. To find standing to attack an unenforceable statutory provision, seeking only declaratory relief, would allow a federal court to issue an impermissible advisory opinion.

The states cited the indirect injury of increased costs to run state-operated medical insurance programs but failed to show how that alleged harm is traceable to the government’s actual or possible enforcement of section 5000A(a). Where a standing theory rests on speculation about the decision of an independent third party (an individual’s decision to enroll in a program like Medicaid), the plaintiff must show at the least “that third parties will likely react in predictable ways.” Nothing suggests that an unenforceable mandate will cause state residents to enroll in benefits programs that they would otherwise forgo. An alleged increase in administrative and related expenses is not imposed by section 5000A(a) but by other provisions of the Act.

Annotation

Primary Holding

States and individuals lack standing to challenge the minimum essential coverage provision of the Patient Protection and Affordable Care Act of 2010.