Supreme Court Appears Likely to Uphold the Affordable Care Act
By: Catherine Caruso
Tags: Justice, Health, Equality, Politics, Society

The Supreme Court appears poised to uphold the Affordable Care Act (ACA), despite Republican-led states’ continued efforts to challenge the constitutionality of the law.

During oral arguments in California v. Texas on Tuesday, at least five Supreme Court justices indicated that they would leave the ACA mostly intact.

Siding with the court’s more liberal justices, Chief Justice John Roberts and Associate Justice Brett Kavanaugh argued that the court could strike down the ACA’s individual mandate without overturning the law in its entirety.

The individual mandate required uninsured individuals to either purchase health insurance or pay a penalty.

While the Supreme Court upheld the constitutionality of the individual mandate in 2012, ruling that the penalty was a legitimate use of Congress’s taxing power, Congress effectively nullified the mandate in 2017 by reducing the penalty to $0.

Because of this, red states are once again calling on the Supreme Court to overturn the entire law, arguing that, without the tax, the ACA is no longer constitutional.

“It’s hard for you to argue that Congress intended the entire act to fall if the mandate were struck down when the same Congress that lowered the penalty to zero did not even try to repeal the rest of the act,” Roberts told Kyle Hawkins, the Texas solicitor general, on Tuesday.

In 2017, Congress tried and failed to repeal the ACA, with 48 Senate Democrats and 3 Republicans voting against the effort.

Roberts acknowledged that while Republican members of Congress may have wanted the court to strike down the law, “that’s not our job.”

Kavanaugh agreed with Roberts’s assessment, calling the case “very straightforward” and claiming that, based on the court’s precedents, “the proper remedy would be to sever the mandate and leave the rest of the act in place.”

Challengers of the ACA have also argued that the law would fall apart without the individual mandate, but even conservative Justice Samuel Alito questioned whether or not the importance of the mandate had been overstated.

The elimination of the penalty has had no real effect on the law. Marketplace enrollment has only minimally decreased since 2017.

“There was a strong reason to think of the mandate like a part of an airplane that was essential to keep it flying,” Alito said. “But now it has been taken out, and the plane has not crashed. So how would we explain that the mandate in its present form is essential to the operation of the act?”

While the the ACA has often been tossed around as a political football, overturning it would impact more than 20 million Americans who rely on the law for healthcare coverage.

Without it, people with preexisting conditions like asthma, cancer, and diabetes would once again be subject to discrimination by health insurance providers. Women and LGBTQ+ people who rely on the ACA’s gender-based protections would also be negatively impacted.

Not to mention, young adults on their parents’ policies and low-income adults who gained access to Medicaid under the law would be among the majority of those to lose their coverage.

The court ruling to sever the individual mandate from the rest of the law, as Roberts and Kavanaugh suggested, would be the best possible outcome for those who rely on the ACA for access to healthcare, especially those with preexisting conditions.

If Tuesday’s oral arguments are any indication of how the Supreme Court will rule in the spring, the ACA will likely live to see another day.