The Affordable Care Act is a 2,700-page piece of legislation passed on March 23, 2010. The goal of the ACA is to reduce the number of uninsured Americans. The act's goal is not without controversy - approximately 30 lawsuits have been filed questioning Constitutionality of the ACA. This presentation gives a brief overview of the Affordable Care Act and what the main debate is all about.

1. Affordable Care Act Overview

2. ACA Background
Patient Protection and Affordable Care Act of 2010,
or PPACA – signed March 23, 2010.
Health Care and Education Reconciliation Act of
2010, or HCERA – signed March 30, 2010.
PPACA + HCERA = Affordable Care Act, or ACA.

3. ACA Goals
Reduce the number of uninsured Americans
by:
• Requiring employers to provide coverage
(preferential tax treatment)
• Requiring Americans to have coverage or be
penalized (individual mandate)

4. ACA Goals
Reduce the number of uninsured Americans
by:
• Creating credits and subsidies if employer does
not offer coverage
• Expanding Medicaid by widening eligibility
requirements

5. ACA Goals
Reduce the number of uninsured Americans
by:
• Providing offsets to fund the law (taxes and
Medicare cuts/changes)

6. ACA Goals
Reduce the number of uninsured Americans
by:
• Providing offsets to fund the law (taxes and
Medicare cuts/changes)

7. ACA Controversy
Approximately 30 lawsuits filed (states,
organizations, lawmakers, private citizens)
Cases filed and appealed in federal courts:
U.S. Circuit Plaintiffs’ Standing Anti-Injunction Act Ind. Mandate ‘Caid Expansion
3rd Circuit No Standing
4th Circuit ACA Cases Barred
6th Circuit Upheld
8th Circuit No Standing
9th Circuit No Standing
11th Circuit Struck Down Upheld
D.C. Circuit Upheld

8. Challenging the Constitutionality
2 appellate cases from Florida (11th Circuit) selected
26 state Attorney Generals, National Federation of
Independent Businesses and others included in
appellate cases
The Supreme Court decision is expected before
July 1st

9. The 4 Major Issues with ACA
• Anti-Injunction Act (AIA)
o Lawsuits over taxes cannot be heard before tax is
assessed.
o Is the fine for no coverage a penalty or a tax?
2. Individual Mandate
o Constitution delineates clear powers to federal and
state government.
o Under the Constitution, does Congress have the
power to force Americans to buy coverage under
threat of penalty?

10. The 4 Major Issues with ACA
1. Medicaid Expansion
o ACA extends coverage through expansions in Medicaid.
o Is required state Medicaid expansion unduly coercive /
violates federalism?
2. Severability
o Many ACA provisions are dependent upon Individual
Mandate and Medicaid Expansion
o If found unconstitutional, what of ACA can remain as
severable?