Sissel v. United States Department of Health and Human Services (2014)

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Issue

Whether the individual mandate clause in the Patient Protection and Affordable Care Act, or “Obamacare,” which requires health insurance coverage or a shared responsibility payment, violates the Commerce and Origination Clauses.

Facts

Matt Sissel was an artist and a small-business owner, and he served part-time as a public affairs specialist with the National Guard. He was financially stable and had the means and preference to pay for all of his medical expenses out-of-pocket. The Affordable Care Act ACA mandated, however, that individuals either acquire a minimum essential health insurance coverage or pay the shared responsibility payment. Sissel failed to qualify for any of the exemptions from the mandate, so he had to alter his financial plans to pay. The penalty fee for failing to purchase approved health insurance ranged from a few hundred dollars to a maximum of $2,085 per family, per year. Sissel claimed his refusal to pay and the ensuing penalty forced him to discontinue his education and rely on sales from his artwork to pay the fee.

He sued the federal government, claiming Congress exceeded its powers under the Commerce Clause by compelling him to purchase insurance. Second, he claimed the ACA’s payment obligations violated the Origination Clause, which requires bills for raising revenue to originate in the House of Representatives. The ACA raised revenue to support the government, he claimed, but it originated in the Senate. Sissel filed suit against the Department of Health and Human Services DHHS in 2010, but the case was postponed until late 2012 to account for the Court’s decision in Mead v. Holder.

Courts Below

The United States Court for the District of Columbia was the first to hear the case. The court ruled in favor of DHHS, holding that the individual mandate was constitutional, was not subject to the Origination Clause, and even assuming it were, the Affordable Care Act indeed originated in the House. See opinion below:

Sissel v. United States Department of Health and Human Services, 951 F.Supp.2d 159 2013

Sissel appealed to the United States Court of Appeals for the District of Columbia Circuit. The circuit court ruled in favor of the DHHS, holding that the Affordable Care Act was not subject to the Origination Clause. See opinion below:

Sissel v. Department of Health and Human Services, 760 F.3d 1 2014

Sissel appealed to the Supreme Court, but the Court declined to hear the case without comment.

Questions before the Supreme Court

Did Congress exceed its authority compelling individuals to engage in commerce by requiring them to purchase health insurance or face a financial penalty?

Was the ACA a “Bill[] for raising revenue” that did not “originate in the House of Representatives,” in violation of Article I, Sect. 7?

CCJ filed an amicus curiae brief in support of Sissel

Summary

The ACA was drafted by the Senate and then “amended” into a bill with a House of Representatives bill number. The Congressional Budget Office termed this process as “an amendment in the nature of a substitute,” meaning that nothing of the original House measure survived. This was an unconstitutional procedure. First, the design of government in the Constitution includes structural limitations on the exercise of power in order to protect individual liberty and self-government. The tax powers of Congress in particular were specific and regulated. Second, the Origination Clause is a critical component of procedural limitations on Congress’s power, and the ACA violated the requirement that bills for raising revenue originate in the House of Representatives.

The Framers granted Congress the power to tax, but were careful to limit that power with other provisions in the Constitution, such as the requirement that Congress can only pass taxes to “pay… debts and provide for the common defence and general welfare of the United States” Article I, Section 8. Moreover, there are limits on those parameters. For example, Congress is required to apportion taxes according to population, as determined by the decennial census; Congress cannot tax any articles exported from any state; and Congress cannot levy taxes unless they originate in the House of Representatives. These provisions work together to limit a power that the Framers feared would otherwise be too broad and too susceptible to abuse. Procedures set down in the Constitution for exercise of Congressional power were deliberately structured to produce “conflicts, confusion, and discordance” as a means of assuring “full, vigorous, and open debate on the great issues affecting the people and to provide avenues for the operation of checks on the exercise of governmental power.” Efficiency was not the goal in this design. Because the design is to check power, it comes as no surprise that neither Congress nor the president can waive these constitutionally mandated procedures.

There was no question that the Origination Clause was meant to vest power in the House and largely remove it from the Senate, checking the power through immediate political accountability. There is also no doubt that this was seen as a limit on the power of Congress to enact taxes. The entire House of Representatives must stand for reelection biennially. This frequency of elections affords the voters an ultimate check on the actions of its representatives. James Madison wrote in Federalist No. 52 that because a common interest between the people and the government was essential to protect liberty, it was just as essential that the House should be immediately dependent upon the people, and “[f]requent elections are unquestionably the only policy by which this dependence and sympathy can be effectually secured.” The way in which the Affordable Care Act was drafted and passed in Congress sidesteps a critical part of the American system of government.

Final Outcome

United States Court of Appeals for the District of Colombia dismissed the case for a failure to state a cause of action, affirming the district court’s ruling in opposition to CCJ’s position. The lower courts determined that the Constitution authorizes Congress to regulate commerce among the states and that the purpose of the Affordable Care Act is to increase those covered by health insurance, not raise revenue. Therefore, the shared responsibility payment is not a bill for raising revenue within the Supreme Court’s accepted meaning of the phrase, which means it is not subject to the Origination Clause, and there is no need to determine if it originated in the House or Senate. The plaintiff appealed twice more to the circuit court for rehearing and once to the Supreme Court. The circuit court denied rehearing each time and the Supreme Court denied petition for certiorari.