The ACA Lawsuits: AHL Looks at Their Beginnings, Their Journeys through the Courts, and Their Future

Topics: Health Care Reform, Legal Issues, Health Care Legislation

In early 2011 on American Health Line's AHLAlerts blog, senior staff writer Santosh Rao examined some of the prominent legal challenges that were filed against the federal health reform law after its enactment in March 2010. Of the nearly two dozen lawsuits, at least 13 of them were dismissed on procedural grounds. AHL covered the developments in five standing cases, which proceeded to the midlevel appeals courts.

Here is a summary of what Santosh covered in the four parts of the legal challenges series, and a selection of links that might provide additional insight about the cases.

Click Here for Part I:

  • The two provisions in the health reform law that are at the center of the lawsuits are the individual mandate and the scheduled Medicaid expansion.
  • Some state officials faced challenges when they expressed their opposition or support for the lawsuits.
  • In the Virginia lawsuit, a federal judge ruled that the individual mandate is unconstitutional. However, the judge did not invalidate the law.

Click Here for Part II:

  • The multistate lawsuit, which was initiated by Florida’s former attorney general, is considered the most prominent of the various lawsuits.
  • The lawsuit’s plaintiffs include top state officials from 26 states, most of whom are Republican; the National Federation of Independent Businesses; and two private individuals.
  • The federal judge in the case ruled against the individual mandate and invalidated the entire law, saying that the mandate is inseparable from the rest of the law.

Click Here for Part III:

  • Besides the Virginia and Florida lawsuits, two other suits — in Lynchburg, Va., and Ann Arbor, Mich. — gained prominence because of their outcomes.
  • The presiding judges in both suits upheld the health reform law, ruling that it falls within the limits of Congress to regulate interstate trade.
  • Oklahoma became the 28th state to challenge the health reform law and the second, after Virginia, to file a stand-alone state challenge in federal court.
  • The U.S. Supreme Court rejected an independent appeal to consider a California lawsuit before it had been fully litigated in the lower courts.

Click Here for Part IV:

  • The federal government claimed victory in two of the four lawsuits that have been decided in federal district courts.
  • Those cases were heard by judges nominated by President Clinton, while the judges presiding over the two cases in which the rulings favored the plaintiffs were nominated by Presidents Reagan and George W. Bush.
  • The two Virginia lawsuits and the Michigan lawsuit have advanced to the midlevel appellate courts of the Fourth and Sixth circuits, respectively. The multistate lawsuit is headed to the appeals court of the Eleventh Circuit, which is considered one of the most conservative in the country.
  • Although one federal judge ruled that the mandate and the law are unconstitutional, he did not issue an injunction on the law.
  • Despite the judge’s ruling, the Obama administration, Democratic lawmakers and various business groups insisted that they will proceed with the implementation as scheduled.

Useful & Interesting Links


  • U.S. District Court Judge Roger Vinson’s ruling (Multistate/Florida)
  • U.S. District Court Judge Henry Hudson’s ruling (Virginia)
  • U.S. District Court Judge George Steeh’s ruling (Michigan)
  • U.S. District Court Judge Norman Moon’s ruling (Lynchburg, Va.)


  • Ian Gershengorn: A New York Times feature on the lead attorney for the Obama administration in the challenges.
  • David Rivkin: A Sunshine State News profile of the lead attorney for the plaintiffs in the multistate lawsuit.