State of Florida, et al. v. U. S. Dept. of Health and Human Serv., et al.

Plaintiffs brought this action challenging the constitutionality of the Patient Protection and Affordable Care Act, Pub. L. 111-148, 124 Stat. 119, amended by Health Care and Education Reconciliation Act of 2010 (HCERA), Pub. L. No. 111-152, 124 Stat. 1029 (Act). The government subsequently appealed the district court's ruling that the individual mandate was unconstitutional and the district court's severability holding. The state plaintiffs cross-appealed the district court's ruling on their Medicaid expansion claim. The court held that the Act's Medicaid expansion was constitutional. The court also held that the individual mandate was enacted as a regulatory penalty, not a revenue-raising tax, and could not be sustained as an exercise of Congress's power under the Taxing and Spending Clause; the individual mandate exceeded Congress's enumerated commerce power and was unconstitutional; and the individual mandate, however, could be severed from the remainder of the Act's myriad of reforms. Accordingly, the court affirmed in part and reversed in part the judgment of the district court.