Obamacare Is Going Back to the Supreme Court
Health Care

Obamacare Is Going Back to the Supreme Court

REUTERS/Kevin Lamarque

The Supreme Court said Monday that it will consider a case that has the potential to overturn the Affordable Care Act, though a final decision is unlikely before the election in November.

The fate of the health care law has hung in the balance since the Fifth U.S. Circuit Court of Appeals ruled in December that a key provision of the ACA was unconstitutional, opening the door to a complete repeal of the law.

The case: The court will hear an appeal on two consolidated cases, California v. Texas and United States House of Representatives v. Texas, that spring from an effort by a group of Republican-led states – and backed by the Trump administration – to invalidate the Affordable Care Act based on its individual mandate provision, which requires all individuals to obtain health insurance. In 2012, the court cited the mandate penalty as a key factor when it upheld the law in a separate case, saying the penalty was a tax and therefore constitutional. The Republican coalition argues that the ACA became unconstitutional once the individual mandate penalty was reduced to zero in the 2017 tax legislation.

The appeals court did not address a second claim, however, which holds that if the individual mandate is unconstitutional, then the whole law is also unconstitutional and must be thrown out. Instead, it sent the case back to the trial court for additional analysis.

What could happen: A Supreme Court ruling could result in a variety of outcomes, including maintaining the status quo, invalidating some of the ACA’s provisions and overturning the law entirely.

Why it matters: Many experts say that if the lawsuit succeeds and the ACA is overturned, about 20 million people could lose their health insurance, and millions more would be affected by turmoil in the U.S. health care system, which has been modified by the ACA in myriad ways. The Trump administration says it has a plan to deal with the fallout – including the loss of legal protections for people with pre-existing conditions – but has provided no details.

Democrats will make political hay: Although the court’s decision will not be announced until next year, the justices will hear arguments in the fall, possibly as early as October, putting the issue back in the headlines shortly before the election. Democrats see health care as a winning issue and are expected to exploit the administration’s support for the case in the fall.

Newly revived Democratic candidate Joe Biden wasted no time Monday attempting to gain advantage from the court’s announcement. “This fall, Donald Trump will be trying to get the Supreme Court to strike down Obamacare – ripping health insurance away from 30 million Americans, ending protections for 100 million more with preexisting conditions, destroying families, and costing a million jobs,” Biden said in a statement.