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Plea to block health care law denied

Chief Justice John G. Roberts, Jr., on Monday afternoon refused to block the Obama administration from continuing to enforce the new federal health care law, denying a plea by two doctors’ groups who argued that the entire law is unconstitutional because of the way Congress passed it.

The Chief Justice made no comment and issued no opinion as he simply denied a request for an injunction against enforcement pending a final ruling in a federal appeals court.   The application was filed three days ago (Americans Physicians and Surgeons v. Sebelius, 13A699); Roberts acted without asking for a response from the federal government — a clear indication that he saw no genuine issue at this time.

The American Physicians group, along with the Alliance for National Health USA, are pursuing in the U.S. Court of Appeals for the District of Columbia Circuit a challenge to new rules — going into effect today — that seek to regulate how doctors who are not participating in the federal Medicare program can refer patients eligible for Medicare services — such as x-rays and blood tests — to providers who will make such care available.

While some of the groups’ challenges are based on procedural complaints, about how the new rules were prepared, they also have been pursuing a sweeping constitutional claim — that is, that the government can take no action whatsoever under the Affordable Care Act because all parts of it are invalid.  In lower courts, the federal government has argued that the doctors’ groups forfeited that issue by not putting it in their original lawsuit in federal court.

The groups told the Chief Justice in their application, however, that they raised the argument in response to the judge’s order calling for new legal briefs on the meaning of the Supreme Court’s ruling two years ago upholding a key part of the ACA — the mandate that virtually all Americans must have health insurance, or pay a financial penalty.

The Supreme Court based its ruling in favor of the mandate’s validity on the conclusion that it is a form of tax, coming within Congress’s powers under the Constitution’s General Welfare Clause.

Responding to that conclusion, the doctors’ groups put forward an argument that the Constitution’s Origination Clause requires that any tax measure which raises revenue for the federal government must begin its legislative journey in the House of Representatives.  The ACA, the groups said, actually originated in the Senate, when that chamber took an unrelated House bill — dealing primarily with tax relief for members of the armed forces — and then made it the host for the entire ACA.  Because of that maneuver, the doctors’ groups contended, the ACA “is void in its entirety.”

In their plea to the Chief Justice to block any regulation under ACA, the doctors’ organizations conceded that the Supreme Court has not spelled out fully the meaning and limitations of the Origination Clause, but they asserted that the Court has done enough in this area to indicate that the ACA is a tax measure and thus should have started in the House of Representatives.

The Chief Justice’s denial of an injunction to bar enforcement leaves the doctors’ groups with the option of trying to persuade the D.C. Circuit to revive their constitutional argument, while also ruling for them on procedural questions about how the referral rules were put into place.

Recommended Citation: Lyle Denniston, Plea to block health care law denied, SCOTUSblog (Jan. 6, 2014, 4:35 PM),