Monday, January 7, 2018

Will Foster is a high school junior from Chicago, Illinois. Today he’s guest blogging for High School SCOTUS about the Texas court ruling that struck down the Affordable Care Act’s individual mandate. Feel free to check out his SSRN page, where he has also written an article on Janus v. AFSCME. 

The Phantom Mandate: Sebelius’ Tax Holding & The Texas Ruling on Obamacare

By Will Foster

On December 14, 2018, a federal district judge in Texas ruled that a 2017 amendment to the Affordable Care Act had rendered the law’s “individual mandate” unconstitutional. The judge, Reed O’Connor, also declared the remainder of the law inseverable from the challenged provision and thus held the entire statute invalid. Much of the controversy around the decision has focused on its severability ruling, which closely tracks views expressed by the four dissenting Supreme Court justices in NFIB v. Sebelius (2012), a landmark case that upheld the mandate.

However, I am not convinced that Judge O’Connor should have reached the severability question. In my view, his Texas v. U.S. opinion misreads the majority opinion in Sebelius and therefore reaches an incorrect conclusion about the validity of the individual mandate. This provision (26 U.S.C. §5000A(a)) states that non-exempted Americans “shall” procure “minimum essential” health insurance coverage. If they fail to do so, §5000A(b) says they must pay a “penalty,” denominated a “shared responsibility payment.”

The individual mandate reads most naturally (some would argue exclusively) as a requirement to obtain insurance; that’s why it’s usually referred to as a “mandate.” In Sebelius, however, Chief Justice John Roberts and his four conservative colleagues found that such a requirement was not authorized by the Commerce Clause or the Necessary and Proper Clause. In order to avoid striking down the provision, Roberts employed a “saving construction” that interpreted §5000A as merely imposing a tax authorized by Congress’ power to lay and collect taxes. He was joined by the court’s four liberal members to create a five-justice majority for that portion of his opinion — although only Roberts viewed the tax holding as requiring a “saving construction,” since the four liberals believed the Commerce and Necessary and Proper clauses should have been sufficient to uphold the mandate as a true requirement.

It is easy to misunderstand what exactly the five-justice majority ruled in Sebelius regarding the individual mandate. It did not rule that a requirement to obtain insurance was authorized by the taxing power. Instead, it ruled that §5000A(a)’s “individual mandate” did not technically mandate anything at all, but rather merely stated the condition that would trigger the “penalty” in §5000A(b), which the court characterized as a tax. The court then found that §5000A, when interpreted as offering a choice between two lawful options (getting insurance or paying a tax), represented a permissible exercise of the taxing power.

As the court explained, “While the individual mandate clearly aims to induce the purchase of health insurance, it need not be read to declare that failing to do so is unlawful … The Government agrees with that reading, confirming that if someone chooses to pay rather than obtain health insurance, they have fully complied with the law” (Sebelius, p. 37). Indeed, “Those subject to the individual mandate may lawfully forgo health insurance and pay higher taxes, or buy health insurance and pay lower taxes” (p. 44, n. 11). The court’s characterization of §5000A as merely imposing a tax on not having insurance was particularly notable in light of the fact that some legal scholars had tried to persuade the court to uphold the minimum coverage provision as a requirement using the taxing power. The distinction between that position and the one the court actually adopted is subtle but important. Professor Randy Barnett, a leader in the original legal challenge to Obamacare who co-authored the private challengers’ Supreme Court brief, noted the difference just days after the Supreme Court’s ruling came down.

Now, as promised, I’ll turn to the implications of Sebelius for the recent Texas district court decision. As Judge O’Connor explained, “The shared-responsibility payment, 26 U.S.C. §5000A(b), is distinct from the Individual Mandate, id. §5000A(a) … [T]he Plaintiffs challenge only the Individual Mandate, not the shared-responsibility penalty, as unconstitutional” (Texas, p. 20). In late 2017, long after Sebelius, the Tax Cuts and Jobs Act was signed into law. The statute, as relevant here, amended §5000A by reducing the shared responsibility payment to zero, effective January 1, 2019 (statute, p. 39). The language about the payment was not completely excised from the Affordable Care Act; to the contrary, the 2017 Congress essentially only replaced existing income percentages and dollar amounts with “zero percent” and “$0,” leaving the statute looking largely the same as before. But while the change was facially minor, it had major significance. In light of Sebelius’s holding that §5000A provided a choice between either getting insurance or paying a tax, the new edits meant that someone could now both fail to procure insurance and not pay any tax penalty. There was no requirement, and no tax either. In other words, §5000A was entirely toothless.

Or was it? Some alleged that the newfound lack of a tax in §5000A meant that the individual mandate, §5000A(a), could no longer be read as a mere predicate to tax consequences. Instead, these challengers asserted, it now had to be understood as a requirement (which, despite lacking any penalties for noncompliance, would seemingly still be legally binding on Americans). There was no longer any way to avoid construing the mandate in this way. Therefore, the taxing power defense employed in Sebelius was useless. And because Sebelius had made clear that a requirement to obtain insurance was unconstitutional, §5000A(a) was unconstitutional. This was the argument that Judge O’Connor used to strike down the individual mandate a few weeks ago.

Judge O’Connor’s reasoning leads to some strikingly counterintuitive results. It seems to me that if Congress had the power to impose an exaction of $695 or more for uninsured adults using the pre-amendment §5000A (as the Supreme Court held), then Congress should have the power to impose an exaction of any lesser amount — even $0. An argument to the contrary would be rather like saying, “The Constitution gives Congress the power to impose a 10-year prison sentence for x crime, but not the power to impose no prison sentence at all.” That seems like a perverse outcome.

There is another logical oddity in the challengers’ position. Under their theory, the penalty could be set extremely close to zero so long as it stayed non-zero, raising the possibility that the difference of even a single cent could invalidate a provision of the Affordable Care Act (and, if the challengers’ severability analysis controls, the entire law). If Congress set the penalty at one cent, but then changed it to zero cents, would the one-cent difference really have created unconstitutionality where none existed before? Perhaps, I suppose, but it’s certainly an interesting question to ask.

Of course, wholly apart from the merits inquiry, it’s far from clear that the plaintiffs had standing to challenge the mandate in the first place. Judge O’Connor acknowledged that the individual plaintiffs would face no practical consequences were they to stop maintaining minimum essential coverage, but nonetheless found standing because the individuals (being law-abiding citizens) felt they were bound by federal law to maintain such insurance (Texas, pp. 17-18). Therefore, plaintiffs were injured because they had been purchasing insurance they did not want in order to fulfill their legal obligations. And this injury could of course be redressed by invalidation of the individual mandate, which the plaintiffs contended was unconstitutional. There’s a problem with this reasoning, though: As a formal matter, people aren’t legally bound to follow unconstitutional laws. As the Supreme Court put it in Norton v. Shelby County (1886): “An unconstitutional act is not a law; it confers no rights; it imposes no duties; it affords no protection; it creates no office; it is in legal contemplation as inoperative as though it had never been passed” (emphasis added). The court has since qualified this statement, noting that as a practical matter an unconstitutional statute might have engendered reliance interests (before being struck down) that cannot be overlooked. Nevertheless, the basic point still rings intuitively true: American citizens do not have a fundamental obligation to follow unconstitutional “laws.”

Of course, as a practical matter, unconstitutional laws may still cause injury because the government will often keep enforcing these laws until a court makes it stop. But the individual mandate is not currently being enforced: The “penalty” is now $0 and the law does not provide for any other consequences. So the plaintiffs have no standing because, assuming they are correct that the mandate is unconstitutional, they lack any sufficient injury: They are both not legally bound by the mandate and not likely to suffer any practical consequences if they disregard it. Judge O’Connor might respond that I am confusing the merits stage with the standing inquiry by already deciding that the mandate is not a requirement. But by deciding plaintiffs are not bound by the mandate I do not necessarily decide (yet) that the mandate isn’t a requirement; I merely note that, even if it is a requirement, it is unconstitutional and therefore of no force.

The traditional approach to standing, as I understand it, is to assume for the sake of argument that the plaintiffs succeed on the merits. So here we should assume that the mandate is an unconstitutional requirement (as the plaintiffs urge) and then realize that the plaintiffs have no standing because an unconstitutional requirement demands no obedience. Indeed, plaintiffs “cannot manufacture standing merely by inflicting harm on themselves.” Whether the asserted injury is in fact self-inflicted is crucial to establishing whether standing exists. For the reasons stated above, if the statute is unconstitutional then the harm seems to be self-inflicted because plaintiffs’ sole claimed reason for why they continue to maintain minimum essential coverage — that the law compels them to — would not exist. I think this argument seems quite compelling. And there are other related arguments against standing for the individual plaintiffs.

In any event, let’s go back to the merits. In his attempt to justify his position, Judge O’Connor approvingly offered arguments propounded by the dissent in Sebelius and rejected — explicitly or implicitly — by the majority. For example, Judge O’Connor explained that the individual mandate must be a requirement because it uses the word “shall” (Texas, p. 31). This argument was considered and rejected by the Sebelius majority when it decided to construe the mandate as merely a condition that triggered a tax (Sebelius, p. 38). Judge O’Connor also approvingly cited the joint dissenters’ argument that the individual mandate must be a requirement due to the separate set of exemptions the Affordable Care Act provides for the mandate itself as opposed to the penalty (Texas, p. 33). Arguments like this would have been perfectly reasonable before 2012, but in light of Sebelius’s ruling that the mandate is not a requirement, I can’t agree that such arguments are still tenable.

You might be wondering how some distinguished legal scholars arrived at the contrary conclusion. In large part the disagreement seems to be due to the different ways we interpret Sebelius. For instance, Professor Josh Blackman, the author of “Unprecedented,” has defended Judge O’Connor’s ruling on the mandate. Professor Blackman suggests that in 2012 Roberts actually “rejected” the argument that §5000A provided a choice between two equally lawful options: “Roberts … observed that ‘[t]he most straightforward reading of the mandate is that it commands individuals to purchase insurance. After all, it states that individuals “shall” maintain health insurance.’ In other words, no such choice exists.”

Respectfully, I read Roberts’ opinion differently. It seems to me that in describing the “most straightforward” way to read the mandate, the Chief Justice was merely noting that common interpretation before rejecting it as, in essence, legally incorrect, since in his view it would render the provision unconstitutional. Professor Blackman allows that Roberts “was willing to accept [the tax] argument for purposes of the saving construction,” but I would go further and say that Roberts appeared to believe the tax/lawful choice interpretation was the correct and ultimately authoritative construction of the statute. Indeed, as noted above, Roberts and his four liberal colleagues stated explicitly in the majority opinion that “[t]hose subject to the individual mandate may lawfully forgo health insurance and pay higher taxes, or buy health insurance and pay lower taxes” (Sebelius, p. 44, n. 11). That sentence and its surroundings contain no qualifications on that statement; the declaration is categorical and clear. Even more evidence may be found in this statement by the majority: “That Congress apparently regards such extensive failure to comply with the mandate as tolerable suggests that Congress did not think it was creating four million outlaws. It suggests instead that the shared responsibility payment merely imposes a tax citizens may lawfully choose to pay in lieu of buying health insurance” (p. 38).

Let’s get one thing straight: Whether a reading of a text is “fairly possible” does not really depend at all on congressional powers. Considerations of constitutionality only kick in to decide which fairly possible reading to adopt (if there are multiple such readings). Specifically, if there exist one or more fairly possible readings that would make a provision valid, judges are obliged to adopt one of those constructions rather than any other fairly possible constructions that would render the provision invalid.

Now let’s carefully go back through Sebelius. Chief Justice Roberts found that there were two fairly possible readings of §5000A. He felt that one of these — reading the section as imposing a requirement backed by a penalty — was the most natural interpretation of the plain text, and other things being equal he would have preferred to adopt this reading. He concluded, though, that this construction would force him to declare the section unconstitutional. That’s why he turned to the second interpretation he saw as fairly possible: §5000A did not declare failure to have insurance unlawful, but offered a choice between two lawful options. At the time Roberts confronted the issue, these two lawful options were either getting insurance or paying a specified amount of money. Of course, after the elimination of the penalty, the two lawful options are either getting insurance or not doing anything.

Roberts focused on the taxing power in Sebelius because an exaction of a non-zero dollar amount requires an enumerated congressional power (here, the taxing power) to support it, and at the time Congress made those without insurance pay money. But “making” people do nothing — which is now how Congress “penalizes” those who don’t get insurance — requires no constitutional power at all. Neil Siegel recently explained this, in a blog post amusingly titled “Congress’s Inherent Power to Require No One to Do Anything”: “To put it bluntly, Congress does not require an enumerated power to declare that Americans must either do X or else not do X and suffer no consequences. After the 2017 statutory amendment to the ACA, that is what the individual mandate and shared responsibility payment provisions provide.”

The fact that §5000A arguably no longer contains a valid exercise of the taxing power (because it might no longer raise any revenue) does not suddenly make Sebelius’s basic construction of the section inapplicable. Even if the precise circumstances Sebelius faced no longer exist, it does not follow that the proper analysis somehow defaults back to a de novo look at the text’s most natural meaning, which virtually everyone has always agreed is as a requirement-with-penalty. In a December 30 order staying his judgement while appeals proceed, Judge O’Connor doubled down on his initial reasoning. He suggested that an argument like mine “is premised on the view that the Supreme Court’s reasoning in NFIB did not simply craft a saving construction but instead permanently supplanted Congress’s intent by altering the very nature of the ACA” (p. 7). That is essentially what I’m arguing, although for what it’s worth the Supreme Court certainly did not appear to see its reasoning as “supplant[ing] Congress’s intent.” Consider this statement I noted above: “That Congress apparently regards such extensive failure to comply with the mandate as tolerable suggests that Congress did not think it was creating four million outlaws. It suggests instead that the shared responsibility payment merely imposes a tax citizens may lawfully choose to pay in lieu of buying health insurance” (Sebelius, p. 38).

Also, part of the reason I’m hesitant to dismiss the Sebelius tax argument as just an ephemeral “saving construction” is that the four liberal justices who joined Roberts didn’t believe it was a saving construction, but apparently saw it as just an equally valid alternative way of deciding the case. They did not join Parts III–B or III–D of Roberts’ opinion, which explained why a “saving construction” was necessary in order to avoid having to declare the statute unconstitutional. Justice Ginsburg, joined by her three liberal colleagues, wrote, “I agree with the Chief Justice that … the minimum coverage provision is a proper exercise of Congress’ taxing power … Unlike the Chief Justice, however, I would hold, alternatively, that the Commerce Clause authorizes Congress to enact the minimum coverage provision” (Sebelius, pp. 1-2). And she chided Roberts for, in her view, unnecessarily resolving the Commerce Clause question: “The Chief Justice ultimately concludes, however, that interpreting the provision as a tax is a ‘fairly possible’ construction. That being so, I see no reason to undertake a Commerce Clause analysis that is not outcome determinative” (p. 37, n. 12).

Ultimately, the 2017 amendment to the individual mandate didn’t change the basic structure the Supreme Court found in Sebelius, which was a fully authoritative construction of the statute: The law provides a choice between two lawful options. And, unlike in Sebelius, the plaintiffs in Texas challenged only the mandate — §5000A(a) — and not the penalty (Texas, p. 27). Thus, under Sebelius, the plaintiffs in Texas were really just challenging one of two options, not a requirement. But as I explained above, Congress plainly does not require any enumerated power to pass such an “option.” (Marty Lederman cogently made this argument a couple weeks ago.) At a fundamental level, the construction the Sebelius majority imposed on §5000A did not depend on whether the interpretation involved a tax. The majority may have chosen to adopt that reading because it had a tax (and thereby provided a way to maintain the penalty but avoid having to strike down the provision), but the interpretation itself — of a non-mandatory “shall” and a choice between two lawful options — would have been fairly possible regardless. Thus, this basic construction is still valid even if there is no longer any tax. It may not be the interpretation some wanted, but it’s the one the Supreme Court adopted. And it still has the benefit of avoiding unconstitutionality (ut res magis valeat quam pereat) since, as I’ve explained, it would today sustain §5000A. Judge O’Connor’s reading invalidates the provision.

True, my interpretation would mean the individual mandate provision would currently be without any effect, thereby infringing upon the canon against surplusage. Nevertheless, that canon yields readily to context, and in this case it is not hard to imagine why Congress could have wanted to substantively gut the provision with the 2017 amendment. The 115th Congress boasted Republican majorities in both the House and the Senate, and Republicans had made opposition to the Affordable Care Act a rallying cry throughout the decade.

Suggestions that Congress in 2017 consciously intended to get the individual mandate struck down by pulling the floor out from under the saving construction are implausible. Nobody seems to have mentioned any such plan at the time, and I think it’s more likely that the Republican members of Congress simply reasoned, “We know the Supreme Court has ruled that there is no requirement — only a tax — so when we eliminate the tax there will be essentially nothing left of §5000A.” In any event, there is a simple explanation for why Congress left the individual mandate itself intact despite removing the penalty: Due to procedural rules, Congress couldn’t use the Tax Cuts and Jobs Act to repeal the mandate – that would have required a filibuster-proof majority in the Senate, which Republicans didn’t have. All it could do in that act was reduce the associated tax penalty (Texas op., p. 11).

I have tried really, really hard to understand the intricate case made by the law’s challengers and Judge O’Connor. At the end of the day, though, I think that the challengers’ reasoning has too many holes. At least for the time being, I cannot subscribe to their argument. §5000A(a) may be known as the “individual mandate,” but it’s not really a mandate. It’s a mere phantom of one.


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