The plaintiffs filed suit in the U.S. District Court for the District of Columbia, arguing that the ACA was unconstitutional, even in light of the "saving construction" given the law in National Federation of Independent Business 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 Clause and Necessary and Proper Clause.
District Court
On June 28, 2013, U.S. District Judge Beryl A. Howell dismissed the plaintiff's suit, holding that the Commerce Clause challenge to the ACA was foreclosed by the Supreme Court decision in NFIB v. Sebelius, that the Origination Clause challenge failed, as the bill enacting the individual mandate was not a bill for raising revenue, and 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, the district court's decision was affirmed by the United States Court of Appeals for the District of Columbia Circuit. The Court of Appeals concluded that section 5000A of the Internal Revenue Code 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 it was therefore unnecessary 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 NFIB v. Sebelius "necessarily disposes of Sissel's Commerce Clause claim."
Subsequent actions
Plaintiffs filed a petition for rehearing en banc. In August 2015, the petition was denied. Four judges dissented from the denial of rehearing. The judges wrote an opinion dissenting from the denial of rehearing and on the merits of Sissel's claim. They agreed with the three-judge panel's rejection of the petitioner's claim, but offered a different rationale. On January 19, 2016 the Supreme Court denied a writ of certiorari.