On Thursday, June 28th SCOTUS will give a final opinion the Patient Protection and Affordable Care Act (ACA). The drastic and sweeping effects of this ruling will decide the future of American Healthcare and Congress' ability to force American citizens to buy a product from a private company.
Stemming from the 11th Circuit's ruling in 2011, which held that the individual mandate is unconstitutional, the Supreme Court is poised to rule on the issue of severability. In order to determine the severability of the individual mandate, SCOTUS will look to the legislative intent of Congress in enacting the ACA.
As put forth by the American Center for Law & Justice in its amici curiae brief, Congress did not intend the ACA to go forward absent the individual mandate. Two obvious issues are inherent with the notion that the ACA could go forward without the mandate: (1) The severability provision contained in the first Affordable Health Care Act was consciously removed from the final version of the ACA while the individual mandate provision remained in both; and (2) "Congress could not have intended a constitutionally flawed provision to be severed from the remainder of the statute" where the legislation itself would be incapable of functioning properly and effectively without the mandate.
The effects of severing the mandate would be catastrophic to health insurance companies. If the individual mandate is severed from the ACA, "the Act is projected to impose a total net cost of $360 billion on health insurance companies from 2012 through 2021." Without the individual mandate, the cost to insurance companies imposed by the ACA would include $77 billion over ten years stemming from the "slacker mandate", $90 billion in excise taxes on health insurers, and $218 billion as a result of the "Cadillac" tax.
Yet the inevitable cost of advancing the ACA absent the mandate will not fall squarely on the shoulder of health insurers. For consumers, "a steep increase in insurers' costs would necessarily result in an increase in premiums" charged to consumers. Additionally, "hospitals and drug manufacturers face reduced reimbursement for certain Medicare expenditures" likely resulting in increased costs being passed to consumers.
Thus, the individual mandate is fatally necessary for the ACA to have any possible effect in line with Congress' intent. The 2011 holding by the 11th Circuit, in which it found the individual mandate to be an unconstitutional violation of Article I of the U.S. Constitution lends no aid to preserve what remains of this failed legislation.