<P> On November 14, 2011, the Supreme Court of the United States issued a writ of certiorari to the United States Appeals Court for the Eleventh Circuit to consider appeals to its rulings in National Federation of Independent Business v. Sebelius and Florida v. United States Department of Health and Human Services . The Court heard oral arguments March 26--28, 2012 and decided the consolidated case on June 28, 2012 . </P> <P> Although the Supreme Court declared that the law could not have been upheld under an argument based on the regulatory power of Congress under the Commerce Clause, the Court declared that the legislatively - declared "penalty" was constitutional as a valid exercise of the Congressional power to tax, thus upholding the individual mandate . The Court also limited the expansion of Medicaid initially proposed under the ACA . All provisions of the ACA continue to be in effect, with some limits on the Medicaid expansion . </P> <P> As of August 2013, scores of lawsuits were still targeting parts of the ACA . </P> <P> The Pacific Legal Foundation initiated a lawsuit, Sissel v. U.S. Dept . Health & Human Services, in the U.S. District Court for the District of Columbia arguing that the ACA was still unconstitutional, even in light of the "saving construction" given the law in NFIB v. Sebelius, on the ground that the enactment of the essential coverage mandate violated the Origination Clause . The suit also sought clarification from the District Court as to what extent lower courts were legally bound by the conclusion of Chief Justice Roberts and the four dissenting justices that the Act did not pass constitutional scrutiny by way of the Commerce and Necessary & Proper Clauses . On June 28, 2013, the District Court dismissed the plaintiff's suit, holding (1) that the Commerce Clause challenge to the ACA was foreclosed by the Supreme Court decision in NFIB v. Sebelius, (2) that the Origination Clause challenge failed, as the bill enacting the individual mandate was not a bill for raising revenue, and (3) that even if the bill enacting the individual mandate were a bill for raising revenue, the Origination Clause challenge failed because the bill was an amendment to a bill that had originated in the House of Representatives . On July 29, 2014, that decision was affirmed by the United States Court of Appeals for the District of Columbia Circuit . However, the Court of Appeals concluded that section 5000A of the Internal Revenue Code (sometimes called the "individual mandate") was not a "Bill for raising Revenue", and thus was not subject to the restriction in the Origination Clause of the Constitution . The Court of Appeals stated that, therefore, there was no reason for the Court to determine whether the bill originated in the House of Representatives . The Court also rejected Sissel's contention that the law violated the Commerce Clause of the Constitution, stating that the U.S. Supreme Court's decision in 2012 in the case of National Federation of Independent Business v. Sebelius "necessarily disposes of Sissel's Commerce Clause claim ." </P>

Legal challenges that have been made against the affordable care act