The Supreme Court has announced it will consider an appeal defending the Affordable Care Act (ACA) against a legal attack from a group of Republican states that was decided in a lower court. The Supreme Court is not placing the case on an accelerated schedule, so it likely won’t determine the fate of the ACA until after the justices’ next term begins in October 2020.
In December 2019, the New Orleans–based Fifth U.S. Circuit Court of Appeals ruled that the ACA’s individual insurance mandate requiring Americans to have health insurance coverage or pay a penalty was unconstitutional, but avoided saying whether the rest of the ACA could remain intact without that mandate. The appeals court also ordered U.S. District Judge Reed O’Connor to reconsider his ruling that the entire health law was invalid.
Republican plaintiffs issued the call to repeal the ACA in 2017, after Congress reduced the individual mandate penalty to $0. “Without the individual mandate, the entire law becomes unsupportable,” said Texas Attorney General Ken Paxton. “The federal government cannot order private citizens to purchase subpar insurance that they don’t want, and I look forward to finally settling the matter before the U.S. Supreme Court.”
However, ACA supporters argue that eliminating the individual mandate penalty did not make the law unconstitutional, just less burdensome. “As Texas and the Trump administration fight to disrupt our health-care system and the coverage that millions rely upon, we look forward to making our case in defense of the ACA,” California Attorney General Xavier Becerra said. “American lives depend upon it.”
The Trump administration, which has pledged to roll back the health law, is not defending the law in court, and the ACA remains in effect during the litigation. White House officials say they do not plan to release any contingency plan this year in case the law is repealed.
Much of the increase in health care coverage under the ACA has been a result of the law’s expansion of the Medicaid program. If the law is terminated, state budgets would struggle to continue this program, as federal funds pay for most of the Medicaid expansion – and subsidies for about 9 million people who buy their insurance from the ACA marketplace.