WASHINGTON – The Affordable Care Act faced a third major challenge in the Supreme Court on Thursday.
A majority of seven judges ruled that Republican plaintiffs had not suffered the type of direct harm they would be suing.
The court neglected the bigger questions in the case: whether most of the sprawling 2010 Health Act, the defining domestic legacy of President Barack Obama, could exist without a provision that initially required insurance or fines for most Americans.
In the years since the bill was passed in 2010, Republicans have worked hard to destroy it, and President Donald J. Trump has been relentlessly critical of it. Attempts to overturn it failed, however, as did two previous Supreme Court challenges in 2012 and 2015. Over the years, the law grew in popularity and became woven into the fabric of the healthcare system. His future now seems certain.
The abolition of the Affordable Care Act would have added about 21 million people to the uninsured in the United States – an increase of nearly 70 percent – according to recent estimates by the Urban Institute.
The largest insurance loss would have occurred among low-income adults who were legally eligible for Medicaid after most states expanded the program to include them. But millions of Americans would also have lost their private insurance, including young adults who were legally allowed to stay with their parents until the age of 26 and families whose incomes were modest enough to receive subsidies to pay their monthly premiums.
A ruling against the law would also have doomed the protection of Americans with past or current health problems – or pre-existing conditions – to fail. The protective measures prevent insurers from denying them coverage or charging them more for it.
The California v Texas case, No. 19-840, was filed by Republican officials who said the mandate requiring health coverage was unconstitutional after Congress lifted the penalty for lack of coverage in 2017 because the Mandate could no longer be justified a tax.
The argument was based on the court’s 2012 ruling in which presiding judge John G. Roberts Jr., along with the then-four liberal wing of the court, said the mandate was authorized by the power of Congress to assess taxes been.
The new challenge was largely successful in the lower courts. A federal judge in Texas ruled the entire law was invalid, but he postponed the effects of his ruling until the case could be appealed. In 2019, the United States Appeals Court for the Fifth District in New Orleans agreed that the mandate was unconstitutional, but declined to rule on the further fate of the Health Act and asked the lower court to consider the matter further .
