Affordable Care Act Litigation: The Standing Paradox

35 Pages Posted: 10 Feb 2012 Last revised: 20 Oct 2015

See all articles by Elizabeth Weeks

Elizabeth Weeks

University of Georgia School of Law

Date Written: February 9, 2012


The Patient Protection and Affordable Care Act (ACA) litigation presents a standing paradox. In the current posture, it appears that states lack standing to challenge the federal law on behalf of individuals, while individuals possess standing to challenge the federal law on behalf of states. This Article contends that there is no principled reason for this asymmetry and argues that standing doctrine should apply as liberally to states as individuals, assuming states allege the constitutional minimum requirements for standing and especially where the legal challenge turns on allocation of power between the federal government and states. The Article proceeds by cataloguing lower court ACA standing decisions involving state, individual, and association plaintiffs to demonstrate the type of particularized injury allegation that suffices for Article III standing. It then explains how states could similarly allege present-day economic harm resulting from the individual mandate. While states may have no greater claim to judicial review of federal laws than individuals, they should not have any less.

Keywords: Health care, federalism, federal courts, standing, state standing, justiciability, health reform, litigation, Affordable Care Act, individual mandate

JEL Classification: H11, I18, K41

Suggested Citation

Leonard, Elizabeth, Affordable Care Act Litigation: The Standing Paradox (February 9, 2012). 38 American Journal of Law and Medicine 410 (2012). Available at SSRN:

Elizabeth Leonard (Contact Author)

University of Georgia School of Law ( email )

225 Herty Drive
Athens, GA 30602
United States


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