Court Cases

National Federation of Independent Business v. Sebelius (2012)

This is the case that many observers thought would strike down a core provision of the ACA – the individual mandate to purchase insurance. The plaintiffs argued that both the individual mandate and the requirement that states expand Medicaid were unconstitutional. The Court upheld the individual mandate, but held the Medicaid expansion must be voluntary for states. You may read the decision here.

Burwell v. Hobby Lobby (2014)

Under the ACA, employer-provided health insurance must include coverage for “preventive care and screenings” without co-pays. The regulations explaining that provision included contraceptive coverage in the category of “preventive care.” Hobby Lobby and others, all closely-held for-profit corporations, sued, claiming that providing access to certain kinds of contraception would conflict with their sincerely-held religious beliefs, and that an earlier law passed by Congress gave the companies the right to be exempted from offering this coverage. The Court agreed: closely-held for-profit corporations could invoke the Religious Freedom Restoration Act and refuse to provide contraception coverage.  You may read the decision here.   

King v. Burwell (2015)

The plaintiffs in this case were trying to find a way to undo the effects of the individual mandate by expanding the number of people who would be exempt from it.

The ACA required states to set up and run insurance exchanges allowing residents to purchase insurance, and if a state did not do so, the federal government would establish the exchange. As the law was implemented by the federal government, tax credits were available to eligible individuals regardless whether they purchased from a state-run or federal-run exchange. Residents of Virginia, which did not set up its own exchange, sued, claiming that the text of the ACA did not allow tax credits for people who purchased insurance on a federal exchange. The plaintiffs argued that if they did not receive the tax credits, then the marketplace insurance would be considered unaffordable for them under IRS rules, and that they would therefore be exempt from the ACA mandate to buy insurance. The court rejected this argument, and tax credits are available for any income-eligible purchaser on both state and federal exchanges. You may read the case here