Supreme Court upholds Affordable Care Act, keeping Obamacare in place

US Supreme Court

US Supreme Court

The Supreme Court on Thursday turned back its third chance to upend the Affordable Care Act, rejecting a lawsuit filed by a group of Republican state attorneys general claiming that a change made by Congress in 2017 had rendered the entire law unconstitutional.

Justice Stephen Breyer wrote the majority ruling in the case, "California v. Texas".

"A big win for the American people", Democratic President Joe Biden, whose administration opposed the lawsuit, wrote in a Twitter post, adding that millions of people rely upon the law for healthcare coverage while encouraging others to sign up.

Texas and other Republican-leaning states, backed by the Trump administration, sought to strike down the law on technical arguments after Congress reduced to zero the tax penalty for failing to carry health insurance. They argued that without the mandate, a pillar of the law when it was passed, the rest of the law should fall, too.

"Neither the individual nor the state plaintiffs have shown that the injury they will suffer or have suffered is "fairly traceable" to the "allegedly unlawful conduct" of which they complain". The threat of elimination - which failed when the late Senator John McCain of Arizona gave a memorable thumbs down in an early morning vote in 2017 - put a spotlight on popular provisions of the law, notably its prohibition on insurers charging sick people more for coverage and its list of "essential health benefits", like hospitalization and maternity care, that must be covered. "No such remedy exists here".

In another case in 2012, NFIB vs. Sebelius, the court narrowly upheld the law by a 5-4 margin and found that the individual mandate was a tax and that states could not forcibly be required to expand Medicaid. "But the legislature is where future battles about health care are likely to play out rather than the courts and the Supreme Court, in particular", she said. The Supreme Court reverses the lower court's ruling on the individual mandate.

Justice Amy Coney Barrett, a Trump appointee whose 2020 confirmation hearing included questions from Democrats over whether she would vote to invalidate Obamacare, joined the majority in the ruling. Justices Samuel Alito and Neil Gorsuch were the only members of the nine-person court who dissented.

Most of it, including tax subsidies to help people afford coverage and, in 39 states (including the District of Columbia), expanded eligibility for Medicaid, the US health insurance program for low-income Americans.

The states' lawsuit should have been able to proceed, Alito argued.

As death rate slows, USA exceeds 600000 COVID-19 fatalities
By comparison, it took just over one month for the USA death toll to surge from 400 ,000 to 500,000 this past winter. The United States has racked up by far the largest death toll of the pandemic, ahead of Brazil and India.

Timothy Jost, JD, emeritus professor of law at Washington and Lee University in Lexington, Virginia, agreed.

"We do not reach these questions of the Act's validity, however, for Texas and the other plaintiffs in this suit lack the standing necessary to raise them". In other words, did the provisions they singled out harm them in a way that the court could fix?

In December of 2019, a federal appeals court held that the individual mandate was unconstitutional.

While, in theory, the decision creates an opening for a plaintiff who can show standing, Jost sees that as very unlikely.

Leaders at the Heritage Foundation, a conservative think tank, drew a similar conclusion.

He reopened the federal Healthcare.gov market from February 15 to August 15, allowing more people who are uninsured during the pandemic to sign up for health coverage. But more than 20 million Americans now depend on it for their health insurance.

Advocates of the landmark healthcare law, however, were delighted and relieved. Key Obamacare consumer protections that also remain in place allow children to stay on a parent's policy until age 26, require insurance companies to treat people with preexisting conditions equally and prohibit the imposition of annual or lifetime coverage limits.

But it's not clear what Republicans can do, said Larry Levitt, an executive vice president for the nonprofit Kaiser Family Foundation, which studies health care.

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