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Down the Rabbit Hole: The Affordable Care Act Saga Continues in the Courts

Elizabeth Wiley, JD, MPH

Vice President for Internal Affairs

Last Thursday, the Fourth Circuit (Maryland, Carolinas, Virginia, West Virginia) rejected two similar cases challenging the constitutionality of the Affordable Care Act. In Liberty University v. Geithner, the court held that the hypothetical penalties an individual might face under the individual mandate for failing to obtain health insurance constitute a tax. Under the Tax Anti-Injunction Act, such a tax can only be challenge by a taxpayer after paying the allegedly unconstitutional tax. Only then may an individual challenge the constitutionality of a tax and seek a refund. As a result, the constitutionality of the individual mandate may not decided until 2014 at the earliest. In Virginia v. Sebelius, the court similarly held that the state of Virginia did not have standing to challenge the constitutionality of the Affordable Care Act.

While the Fourth Circuit decisions have been widely heralded as another victory for the administration, the procedural nature of the decisions renders them quite limited in scope. For those of you keeping the Circuit score - it looks like a 1-1-1 right now...

4th Circuit: Dismissed (procedural).

6th Circuit: Constitutional.

11th Circuit: Unconstitutional.

The American Medical Student Association joined amicus briefs filed by the Center for American Progress, the American Academy of Pediatrics, the National Physicians Alliance, Doctors for America, the National Hispanic Medical Association and the American Nurses Association in both of the Fourth Circuit Affordable Care Act cases.

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