The Supreme Court announced Thursday that it has rejected a lawsuit filed by a group of Republican-led states and the former Trump administration that sought to overturn the Affordable Care Act, commonly known as Obamacare.
In a 7-2 vote, the court ruled that the plaintiffs lacked the legal standing to bring the suit because they had not been harmed by the law. Accordingly, the ruling does not address the merits of the case.
In their dissent, Justices Samuel Alito and Neil Gorsuch argued that the plaintiffs had in fact been harmed financially and administratively. “The States have clearly shown that they suffer concrete and particularized financial injuries that are traceable to conduct of the Federal Government,” Alito wrote. “The ACA saddles them with expensive and burdensome obligations, and those obligations are enforced by the Federal Government. That is sufficient to establish standing.”
The ruling in the case, California v. Texas, marks the third time the court has taken up a case that could overturn the ACA, and the third time it has declined to do so.
What the case was about: Republican officials in Texas and 17 other states sued the federal government in 2018 seeking to overturn the ACA, arguing that the law became invalid in its entirety when the individual mandate – the penalty for not purchasing health insurance – was reduced to zero by Congress in 2017 as part of its overhaul of the tax code. The Trump administration backed the suit and filed a brief in 2020 urging the Supreme Court to strike down the law.
Supporters are relieved: Democrats cheered the court’s ruling. President Joe Biden said the “Affordable Care Act remains the law of the land,” while Senate Majority Leader Chuck Schumer of New York said the decision means that “the ACA is here to stay.” House Speaker Nancy Pelosi of California took aim at the GOP, saying, “We will never forget how Republican leaders embraced this monstrous suit to rip away millions of Americans’ health care in the middle of a deadly pandemic.”
The American Medical Association also expressed support for the ruling. “With yet another court decision upholding the ACA now behind us, we remain committed to strengthening the current law and look forward to policymakers advancing solutions to improve the ACA,” Gerald Harmon, the organization’s president, said in a statement.
The roughly 31 million Americans who now have health insurance as a result of the ACA, as well as millions more who are covered by its provisions, including rules governing pre-existing conditions, are probably breathing a little easier, as well. A ruling in favor of the plaintiffs could have resulted in millions of people losing their coverage and regulatory chaos throughout the health care system.
Looking ahead: “With the threat to the ACA's existence now in the rearview mirror, attention turns to how to fill in its gaps,” tweeted Larry Levitt of the Kaiser Family Foundation, citing temporary premium assistance, incomplete Medicaid expansion and high health care costs as issues that need to be addressed.
“I'd say the decade long debate over whether the Affordable Care Act should exist is over,” Levitt added. “We can now return to the longstanding ideological debate over the role of government in restraining health care costs and providing coverage to people.”