The Supreme Court has dismissed a challenge to the Obama-era health care law, preserving insurance coverage for millions of Americans.
The justices, by a 7-2 vote, left the entire law intact Thursday ruling that Texas, other Republican-led states and two individuals were barred from bringing their lawsuit to a federal court. The Biden administration says 31 million people have health insurance because of the law popularly known as “Obamacare.”
Key provisions of the law include protections for people with pre-existing health conditions, a range of free preventive services, and the expansion of the Medicaid program that insures low-income people, including those in low-paying jobs or provide health insurance.
The law’s now toothless requirement that people must have health insurance or pay a penalty is also left in place. Congress made this provision irrelevant in 2017 when it reduced the penalty to zero.
Eliminating the penalty had become the hook that Texas and other Republican-run states, as well as the Trump administration, used to attack the entire law. They argued that without the mandate, a pillar of the law when it was passed in 2010, the rest of the law would also have to fall.
And with a more conservative Supreme Court that includes three Trump appointees, opponents of Obamacare hoped a majority of justices would finally kill the law they’ve been fighting for more than a decade.
But the third major attack on the law in the Supreme Court ended like the first two, with the majority of the court pushing back against efforts to gut the law or get rid of it altogether.
Trump’s three Supreme Court appointees – Justices Amy Coney Barrett, Neil Gorsuch and Brett Kavanaugh – split their votes. Kavanaugh and Barrett joined the majority. Gorsuch disagreed, signing an opinion from Judge Samuel Alito.
Judge Stephen Breyer wrote for the court that the states and individuals who brought the federal lawsuit “have not demonstrated that they have standing to attack as unconstitutional the statute’s minimum essential coverage provision.”
Dissenting, Alito wrote, “Today’s ruling is the third installment in our epic Affordable Care Act trilogy, and it follows the same pattern as installments one and two. In all three episodes, with the Affordable Care Act facing a grave threat, the Court pulled off an unlikely rescue.” Alito also dissented in the previous two cases.
Because it dismissed the case for the plaintiff’s lack of legal capacity — the ability to sue — the court hasn’t actually ruled on whether the individual warrant is unconstitutional now that there is no penalty for waiving insurance. Lower courts had overturned the warrant, in rulings that were overturned by the Supreme Court’s decision.
With the latest decision, the ACA is “here to stay for the foreseeable future,” said Larry Levitt, executive vice president of the nonprofit Kaiser Family Foundation, which studies health care.
“Democrats are in the driving seat and they have made revitalizing and building the ACA a key priority,” Levitt said. “Republicans don’t seem to have much enthusiasm to keep trying to overturn the law.”
Republicans have pressed their case for invalidating the entire law, even as congressional efforts to rip out the entire law “root and branch,” in the words of GOP Senate Leader Mitch McConnell, have failed. They came closest in July 2017, when Arizona Senator John McCain, who died the following year, cast a vote in favor of a repeal effort by his fellow Republicans.
Chief Justice John Roberts said during oral arguments in November that it appeared the enemies of the law were asking the court to do the job best left to the political branches of government.
The court’s decision preserves benefits that have become part of the fabric of the country’s health care system.
Polls show the 2010 Health Care Act has grown in popularity as it came under the fiercest assault. In December 2016, just before Obama left office and Trump called the ACA a ‘disaster,’ 46% of Americans had an unfavorable view of the law, while 43% approved, according to the Kaiser’s tracking poll. Family Foundation. Those ratings reversed and in February this year 54% had a favorable opinion, while disapproval had fallen to 39% in the same ongoing poll.
The health law is currently undergoing an expansion under President Joe Biden, who sees it as the basis for moving the United States to coverage for all. His giant COVID-19 relief bill dramatically increased subsidies for private health plans offered in ACA insurance marketplaces, while suspending higher federal payouts ahead of the dozen states that refused. Medicaid expansion of the law. About 1 million people have registered with HealthCare.gov since Biden reopened registrations amid high levels of COVID cases earlier this year.
Most people insured by law have it through Medicaid expansion or health insurance marketplaces that offer subsidized private plans. But its most popular benefit is protection for people with pre-existing medical conditions. They cannot be declined for coverage due to health issues or charge a higher premium. While people covered by employer plans already had such protections, “Obamacare” guaranteed them to people with individual policies.
Another hugely popular benefit allowed young adults to stay on their parents’ health insurance until they turned 26. Before the law, going without medical coverage was like a rite of passage for people in their twenties just starting out in the world.
Because of the ACA, most privately insured women receive free birth control. It is considered a covered preventative benefit at no additional cost to the patient. The same goes for routine screenings for cancer and other conditions.
For Medicare beneficiaries, “Obamacare” has also improved preventative care and, more importantly, closed a multi-thousand dollar gap in prescription drug coverage known as the “doughnut hole.”