Supreme Court Leaves Affordable Care Act Intact

The Supreme Court on Thursday rejected a challenge to the Affordable Care Act, the third time it has preserved the 2010 healthcare law.

Texas and other Republican-leaning states, backed by the Trump administration, sought to strike down the law on technical arguments after Congress reduced to zero the tax penalty for failing to carry health insurance. Thursday’s 7-2 decision, written by Justice Stephen Breyer, found that none of the plaintiffs suffered any injury from zeroing out the penalty and thus they lacked legal standing to bring the lawsuit at all.

“We do not reach these questions of the Act’s validity,” Justice Breyer wrote. “Texas and the other plaintiffs in this suit lack the standing necessary to raise them.”

Joining the majority were Chief Justice John Roberts and Justices Clarence Thomas, Sonia Sotomayor, Elena Kagan, Brett Kavanaugh and Amy Coney Barrett.

In dissent, Justice Samuel Alito, joined by Justice Neil Gorsuch, accused the majority of ducking the constitutional issues that conservatives for years have argued make the federal healthcare overhaul unconstitutional.

A Texas federal judge ruled in 2018 that the entire health law was invalid, a decision that never went into effect. A year later a federal appeals court agreed that the insurance mandate was unconstitutional, but it ordered the trial court to reconsider whether other parts of the sprawling law could remain in place.

The high court’s decision reversed those rulings. Had the justices voided the ACA, their decision could have thrown the healthcare marketplace into turmoil and led to a considerable increase in uninsured Americans.

A divided Supreme Court previously upheld the mandate in a 2012 decision, based on Congress’s power to levy taxes. Lawmakers in 2017 reduced the penalty to $0 as part of Republicans’ tax overhaul package, and the GOP-led states argued that change meant the mandate could no longer be upheld under the taxing power.

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. It also expanded the availability of Medicaid coverage for limited-income Americans and allowed young adults to stay on their parents’ plans until they turned 26.

The ACA contains hundreds of other provisions, on everything from contraception and vaccine coverage to healthcare fraud and nutritional labeling on restaurant menus.

The case marked the third time the Supreme Court considered the fate of the ACA.

When the Trump administration abandoned defense of the ACA, California and other Democratic-controlled states intervened to defend the law.


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