On August 12, 2011, the U.S. Court of Appeals for the Eleventh Circuit declared the individual mandate provisions of the Affordable Care Act (the Act) to be unconstitutional.  See State of Florida v. U.S. Dep’t of Health and Human Servs., No. 3:10-cv-00091-RV-EMT (11th Cir. 2011).  In a 2-1 decision, the three-judge panel upheld in part an earlier district court decision striking down the individual mandate as a violation of the Commerce Clause of the U.S. Constitution.  Unlike the district court, however, the circuit court upheld the remaining provisions of the Act.

The attorneys general of 26 states had challenged the constitutionality of the Act, arguing that the individual mandate exceeded Congress's power to regulate interstate commerce, and that its expansion of the Medicaid program to include a larger patient population effectively “coerced” states into participating in a voluntary program.  In a 304-page decision, the circuit court held that the individual mandate exceeded the bounds of the Commerce Clause, stating that while Congress has broad authority to regulate interstate commerce, “what Congress cannot do under the Commerce Clause is mandate that individuals enter into contracts with private insurance companies for the purchase of an expensive product from the time they are born until the time they die.”  Calling the mandate “breathtaking in its expansive scope,” the circuit court went on to state that Congress cannot regulate the health care market by regulating individuals who have not yet entered it.  But the circuit court overturned the district court’s decision to invalidate the entire Act, including the Medicaid expansion provisions.

The Eleventh Circuit’s decision follows a June decision by the U.S. Court of Appeals for the Sixth Circuit, which upheld the individual mandate.  A decision from the Fourth Circuit is expected later this year.  That at least two circuit courts have reached different conclusions on the Act’s constitutionality increases the likelihood that the issue will reach the U.S. Supreme Court.  The Eleventh Circuit’s decision is available by clicking here.