Department of Health and Human Services v. Florida

Juvenile Law Center signed on to an amicus brief written by Child Rights Project at Emory University School of Law and Bondurant, Mixson & Elmore, LLP on behalf of child advocacy organizations in support of petitioners on the minimum coverage provision question.

The brief addresses the constitutionality of the provisions of the federal Patient Protections and Affordable Care Act (ACA) that relate to health insurance for children and youth transitioning to adulthood. Among other things, ACA would improve children’s access to health care by creating exchanges through which insurance can be purchased and subsidized, expanding “child-only policies,” requiring coverage of children with pre-existing conditions, removing caps to care in some situations, and requiring insurance providers to make available preventative care and screenings that are evidence based and provide for innovative programs to deliver health care to children in their own homes and schools. The ACA also allows children to stay on their parents’ health insurance until age 26 and requires that children who age out of foster care be covered by Medicaid until age 26. It is projected that the ACA will have a significant impact on children’s health and that it will reduce the number of non-elderly people without insurance by 33 million by 2017.

Amici argued that it is the traditional role of Congress to regulate the market under the Commerce Clause of the Constitution. Moreover, the Supreme Court has consistently affirmed the right of Congress to regulate commercial activities, especially when they relate to the health and well-being of children (which has been done in such well-known areas as child labor). Amici explained how intervention in the market for health insurance is especially appropriate for children who cannot purchase health insurance and do not have full access and control over their health care. Amici also explained the degree to which even with current federal and state efforts and programs to provide health care to children, large numbers of children remain without health insurance. Even more disturbingly, a significant number of youth with special health care needs remain uninsured or lack adequate care. The consequences of poor health for children are far reaching and can extend into adulthood in the form of significant and costly health care needs and poor educational and employment outcomes. Addressing the failure of the marketplace to provide adequate health care for children not only protects children and promotes their well-being, but also helps promote the development of healthy adults who are able to contribute to society.

The United States Supreme Court held that the individual mandate cannot be upheld as an exercise of Congress's power under the Commerce Clause, but that it is a proper exercise of Congress's taxing power. The Court further held that the Medicaid expansion portion of the Affordable Care Act violates the Constitution insofar as it threatens existing Medicaid funding for states that opt out of the expansion.