Supreme Court rejects Republican-led challenge to Affordable Care Act

Supreme Court rejects Republican-led challenge to Affordable Care Act

The Supreme Court ruled that a collection of red states do not have standing to challenge the legality of the Affordable Care Act, choosing to preserve the law once again.

The law's challengers, 18 red states led by Texas, urged the court to rule that Obamacare's requirement for almost all Americans to obtain health insurance or pay an income tax penalty - known as the individual mandate - is unconstitutional. But hundreds of millions more have had their health care and coverage affected by provisions as wide-ranging as changes in Medicare drug copayments, requirements for calorie counts on menus, a pathway for approval of generic copies of expensive biologic drugs and, perhaps most important politically, protections for people with preexisting conditions and a ban on lifetime caps on coverage.

At issue also was the question of whether the rest of the law could stand if the justices believed that those bringing the case did have standing and if the requirement to have health insurance was unconstitutional. They argued that without the mandate, a pillar of the law when it was passed, the rest of the law should fall, too.

"Plaintiffs in this suit failed to show a concrete, particularized injury fairly traceable to the defendants' conduct in enforcing the specific statutory provision they attack as unconstitutional", concluded Justice Stephen Breyer, who penned the majority's decision.

In 2012, Chief Justice John Roberts joined the four liberal justices on the court at the time, NFIB v. Sebelius, for a 5-4 decision that upheld the constitutionality of the individual mandate by deeming it a tax.

It was the third time in nine years the court has been offered the opportunity to effectively end the health law - and the third time it has refused.

Conservative justices Samuel Alito and Neil Gorsuch, who was also appointed by Trump, were the dissenting voices.

The elimination of the penalty had become the hook that Texas and other GOP-led states, as well as the Trump administration, used to attack the entire law.

Timothy Jost, JD, emeritus professor of law at Washington and Lee University in Lexington, Virginia, agreed.

"We do not reach these questions of the Act's validity, however, for Texas and the other plaintiffs in this suit lack the standing necessary to raise them", he said. In other words, did the provisions they singled out harm them in a way that the court could fix? The individual mandate, Mr Paxton wrote on Twitter, "was unconstitutional when it was enacted and it is still unconstitutional".

While, in theory, the decision creates an opening for a plaintiff who can show standing, Jost sees that as very unlikely.

The US Supreme Court on Thursday rejected a Republican bid that had been backed by former President Donald Trump's administration to invalidate Obamacare, preserving the landmark healthcare law for the third time since its 2010 enactment.

In addition to the mandate that most people carry health insurance, the Affordable Care Act barred insurers from denying coverage-or charging more-to people with existing health conditions. (The expanded version of Medicaid enrolls most adults earning up to 138% of the poverty line.) Even with Obamacare in place, 28.9 million Americans lacked coverage in 2019, two million more than in 2016, according to the Kaiser Family Foundation. This favorable ruling means the patient protections, affordability measures, coverage expansions, and market reforms that millions of Americans rely on will remain in place.

Abraham noted that a million more Americans took advantage of the special enrollment period this spring, thanks to "additional cost savings" included in the American Rescue Plan. "In all three episodes, with the Affordable Care Act facing a serious threat, the Court has pulled off an improbable rescue".

But it's not clear what Republicans can do, said Larry Levitt, an executive vice president for the nonprofit Kaiser Family Foundation, which studies health care.

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