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Last week a three-judge panel of the 11th Circuit heard arguments in the 26-state lawsuit challenging the healthcare reform law, The Patient Protection and Affordable Care Act (aka PPACA or The Affordable Care Act or even the ACA to add yet another moniker). The United States had appealed the decision by Judge Vinson of the U.S. District Court for the Northern Division of Florida, which we have discussed in prior posts.  Judge Vinson had ruled that the individual insurance mandate portion of PPACA is unconstitutional and that because the provisions requiring the individual mandate could not be severed from the rest of the law, the entire law was void.  The issues of interest in the appeal are not only the constitutionality of the individual mandate requirement and PPACA at large, but also whether the District Court correctly held that the federal government can force states to expand their Medicaid programs as a precondition for continuing to receive matching federal funds for their Medicaid programs.  McGuireWoods attorneys Shayna Bowen and Amita Sanghvi have published a more detailed description of the June 8^th oral arguments accessible here.

The 11^th Circuit case is one of several cases pending before Federal courts regarding the constitutionality of all or part of PPACA.  The 4^th Circuit heard arguments in mid-May in cases brought by the Commonwealth of Virginia and Liberty University challenging the individual mandate and PPACA generally.  With a surprising three-judge panel comprised of all Democratic appointees, many experts expect the 4^th Circuit to uphold the constitutionally of PPACA in its entirety and the U.S. Supreme Court to then consolidate the 11^th and 4^th Circuit cases for unusually expeditious hearing this fall.

It is also important to note that in the 5^th Circuit, on May 27^th Physician Hospitals of America (PHA) and Texas Spine & Joint Hospital (TSJH) filed an appeal of the ruling by Judge Schneider in the Eastern District of Texas upholding the constitutionality of Section 6001 of PPACA.  We have discussed in several prior posts the key elements of the PHA and TSJH arguments in the 5^th Circuit case, in which a team of McGuireWoods attorneys lead by Scott Oostdyk and Victor Moldovan are representing PHA and TSJH.   If the Supreme Court voids all of PPACA upon hearing one or both of the more global PPACA cases now  pending in the 11^th and 4^th Circuits, the PHA-TSJH case will become moot.

At the same time that the Federal government is defending legal challenges to PPACA through the courts, a variety of legislative challenges are pending as well, including repeal legislation introduced by U.S. Congressmen Sam Johnson (TX-3) and Doc Hastings (WA-4).