The Supreme Court on Thursday turned down its third chance to repeal the Affordable Care Act and dismissed a lawsuit by a group of Republican attorneys general alleging that a 2017 amendment to Congress made the entire law unconstitutional.
With a 7-2 vote, the judges didn’t even get to the point and instead decided that the plaintiff states and the individual plaintiffs, two self-employed Texans, lacked “steadfastness” to bring the case to court.
“We go no further than standing,” wrote Judge Stephen Breyer for the majority. “Neither the individual plaintiffs nor the prosecutors have shown that the damage they suffer or will have suffered is’ largely due to the ‘allegedly illegal behavior’ they complain about.”
The two dissenters in the case, Judges Samuel Alito and Neil Gorsuch, disagreed. “The states have clearly shown that they are suffering concrete and concrete financial damage that can be traced back to the behavior of the federal government,” wrote Alito. “The Court of Auditors gives them expensive and burdensome obligations, and these obligations are enforced by the federal government. That is enough to justify standing. “
The ruling was a win not only for advocates of the Health Law in general, but also for Minister of Health and Human Services, Xavier Becerra. As California’s attorney general, Becerra led the Democratic states defending the ACA after the Trump administration joined the Republican states’ lawsuit.
It was the third time in nine years that the court had been given an opportunity to effectively end the Health Act – and the third time it was denied.
The Democrats quickly declared victory. “The Supreme Court just decided: The Court of Auditors is here to stay,” said Senate Majority Leader Chuck Schumer. House spokeswoman Nancy Pelosi said, “We will never forget how Republican leaders adopted this monstrous suit to wrest health care from millions of Americans in the midst of a deadly pandemic.”
The California v Texas case came about as a result of the tax cut bill passed by Republican-controlled Congress in 2017. As part of this bill, Congress reduced the ACA’s penalty for not having health insurance to zero. The obligation to cover, often referred to as an individual order, was included in the law in order to offer insurers a wide range of customers, as they now had to cover people with illnesses. Republicans have long attacked the provision as a government violation.
Republican attorneys general argued in their lawsuit that it was only the existence of this penalty – which the judges viewed as a tax – that enabled the Supreme Court to rule the law constitutional in 2012. Without the tax, Republicans argued, not only is the mandate of cover unconstitutional, but the rest of the law must fall as well.
At a hearing on the case last November, several Conservative judges made it clear that they would not buy what the Republicans were selling.
On the standing issue, Chief Justice John Roberts asked if anyone would be able to repeal a law requiring homeowners to mow lawns – even if that law did not provide for penalties. His clear suggestion was that such a person would not have a case.
It was also about the question of whether the rest of the law could stand if the judges considered the right to bring an action to be justified and the health insurance obligation was unconstitutional. Even some of the court’s most conservative members, including Judge Brett Kavanaugh, suggested that Congress did not intend to overturn the rest of the law if the individual mandate were declared unconstitutional.
The law, passed in 2010, has insured approximately 31 million Americans. But health care and coverage for hundreds of millions more have been influenced by such far-reaching regulations as changes in Medicare drug co-payments, menu calorie requirements, a way to allow generic copies of expensive biological drugs, and, perhaps most importantly, politics Protective measures for people with previous illnesses and a ban on lifelong cover limits.
The Trump administration took several positions on the case. At one point she claimed that the abolition of the tax required the entire law to be invalidated, and at another time she suggested that the Health Act could only be invalidated in the Republican-controlled states involved in the lawsuit.
Before Judge Ruth Bader Ginsburg’s death last September, most court observers considered the case highly unlikely that the entire Court of Auditors would be crushed. That’s because Roberts voted to uphold the law in 2012 and again when it was less comprehensively challenged in 2015. But conservative lawyer Amy Coney Barrett replaced Ginsburg, and a majority that supported the law were considered less certain.
KHN (Kaiser Health News) is a nonprofit health news service. It is an editorially independent program from KFF (Kaiser Family Foundation) that is not affiliated with Kaiser Permanente.