The provision of a 2010 voter-approved measure saying Arizonans don't have to buy health insurance is unenforceable because it conflicts with the federal Affordable Care Act, a federal appeals court ruled Thursday.
A three-judge panel of the 9th U.S. Circuit Court of Appeals rejected claims brought on behalf of an Arizona resident by the Goldwater Institute that the state constitutional amendment provides protections for Arizonans from the federal directive. The judges also said language in the Arizona amendment prohibiting fines for those who refuse to buy the mandated coverage is similarly unenforceable.
In a wide-ranging ruling, the court also threw out the claims by Nick Coons that the mandate to purchase insurance infringes on his right to “medical autonomy” because it requires him to use his limited financial resources to obtain insurance he does not want.
The judges rebuffed arguments brought on behalf of Eric Novack, an Arizona doctor, that the law is unconstitutional because it could at some point in the future affect his future income from Medicaid patients. They called his allegations “highly speculative and ... not certainly impending.”
Goldwater lawyer Christina Sandefur said she is weighing options for appeal.
The 2010 Affordable Care Act sets up a system to increase the number of individuals covered by medical insurance and decrease the overall cost of medical care.
Here the issue is what is known as the “individual mandate,” which require people to maintain “minimum essential coverage” or have to pay a penalty, termed a “shared responsibility payment” with his or annual income tax return.
Judge Susan Graber, writing for the appellate court, rejected the contention that the Arizona voter-approved measure provides a shield for residents.
She pointed out that the U.S. Supreme Court two years ago upheld the constitutionality of the individual mandate. And what that means, Graber said, is the Arizona measure must fall because it “stands as an obstacle to the accomplishments and execution of the full purposes and objectives of Congress.”
The court was no more receptive to the claim by Coons that he is being forced into a health plan he does not desire.
“The individual mandate does not require that an individual select a particular insurance plan, does not require that the individual use an insurance plan once purchased, and does not restrict an individual's right to contract for care directly with the physician of his or her choosing,” Graber wrote. And she said it's of no legal concern that Coons would have to spend money either on insurance or a penalty.
He just can't refuse to do either.
“To the extent that Coons simply wishes to remain uninsured and free from the mandatory payment, the Supreme Court no longer recognizes such a right as fundamental,” she said, citing that 2012 high court ruling.