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.
By a vote of 7-2, however, the justices did not even reach the merits of the case, ruling instead that the suing states and the individual plaintiffs, two self-employed Texans, lacked “standing” to bring the case to court.
“We proceed no further than standing,” wrote Justice Stephen Breyer for the majority. “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 two dissenters in the case, Justices Samuel Alito and Neil Gorsuch, disagreed. “The States have clearly shown that they suffer concrete and particularized financial injuries that are traceable to conduct of the Federal Government,” Alito wrote. “The ACA saddles them with expensive and burdensome obligations, and those obligations are enforced by the Federal Government. That is sufficient to establish standing.”
The ruling represented a win not only for backers of the health law in general, but also for Health and Human Services Secretary Xavier Becerra. As California attorney general, Becerra led the Democratic states defending the ACA after the Trump administration sided with the Republican states’ suit.
It was the third time in nine years the court has been offered the opportunity to effectively end the health law — and the third time it has refused.
Democrats lauded the decision. President Joe Biden tweeted that the decision is “a big win for the American people.” Becerra, who helped write the law as a member of Congress and now is responsible for implementing it, said the decision “means that all Americans continue to have a right to access affordable care, free of discrimination. More than 133 million people with preexisting conditions, like cancer, asthma or diabetes, can have peace of mind knowing that the health protections they rely on are safe.”
Democratic leaders in Congress said after the ruling that they plan to move ahead with efforts to expand the law — something Republicans are wary of.
“The Supreme Court’s ruling doesn’t change the reality that America’s health care system needs to be modernized to better serve patients,” said Rep. Cathy McMorris Rodgers (R-Wash.). “Instead of lurching toward socialized medicine, we should be working together to modernize our health care system with solutions like price transparency, lowering drug costs without government price control schemes, removing bureaucratic red tape and spurring more private investment for breakthrough cures and treatments.”
The case, California v. Texas, arose as a result of a provision of the tax-cut bill passed by the Republican-controlled Congress in 2017. As part of that bill, Congress reduced to zero the ACA’s penalty for not having health insurance. The requirement for coverage, often referred to as an individual mandate, was inserted into the law to give insurers a wide pool of customers since they were now required to cover people with medical conditions. Republicans have long assailed the provision as an overreach by government.
The Republican state attorneys general argued in their suit that it was only the existence of that penalty — which the justices considered a tax — that allowed the high court to rule the law constitutional in 2012. Without the tax, the Republicans argued, not only is the mandate to have coverage unconstitutional, but the rest of the law must fall, too.
At oral arguments in the case last November, several of the conservative justices made clear they were not buying what the Republicans were selling.
On the standing issue, Chief Justice John Roberts asked whether someone would be able to sue to overturn a law requiring homeowners to mow their lawns — even if that law had no penalty. His clear suggestion was that such a person would have no case.
At issue also was the question of whether the rest of the law could stand if the justices believed that those bringing the case did have standing and if the requirement to have health insurance was unconstitutional. Even some of the court’s most conservative members, including Justice Brett Kavanaugh, suggested Congress did not intend for the rest of the law to fall if the individual mandate were declared unconstitutional.
In the end, only Justices Alito and Gorsuch suggested they agreed with the basis for the suit. “Today’s decision is the third installment in our epic Affordable Care Act trilogy, and it follows the same pattern as installments one and two,” Alito wrote. “In all three episodes, with the Affordable Care Act facing a serious threat, the Court has pulled off an improbable rescue.”
The law, enacted in 2010, has provided coverage for about 31 million Americans. But hundreds of millions more have had their health care and coverage affected by provisions as wide-ranging as changes in Medicare drug copayments, requirements for calorie counts on menus, a pathway for approval of generic copies of expensive biologic drugs and, perhaps most important politically, protections for people with preexisting conditions and a ban on lifetime caps on coverage.
The Trump administration took several positions on the case. At one point it asserted that eliminating the tax required the entire law to be declared void and at another time suggested that the health law could be invalided only in the Republican-controlled states involved in the suit.
Before the death of Justice Ruth Bader Ginsburg last September, most court observers thought the case was highly unlikely to result in the entire ACA being struck down. That’s because Roberts voted to uphold the law in 2012, and again when it was challenged in a less sweeping way in 2015. But conservative jurist Amy Coney Barrett replaced Ginsburg, and a majority to sustain the law was considered less secure.
–Julie Rovner, Kaiser Health News
The News Service of Florida Reported:
In a prepared statement, Florida Attorney General Ashley Moody said her office respects “the ruling and authority of the court.” But the Republican attorney general also defended her involvement in the suit, saying “my office will always push back on any federal overreach limiting the authority of the states.”
But Democrats celebrated the decision upholding the law commonly known as Obamacare.
“Thank goodness,” state Sen. Audrey Gibson, D-Jacksonville, said in a prepared statement. “Unlike the attorney general, the governor and the Republican-led Legislature, the Supreme Court understands the challenges many families face in getting affordable health care.”
Moody, Gov. Ron DeSantis and other Republican leaders have opposed Obamacare, despite the fact that Florida leads the nation in the number of people who enroll in a federal health-insurance exchange under the law.
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Ray W. says
Just a thought exercise, using as my foundation one of the seven individual Consumer Price Index (CPI) categories, to-wit: medical CPI. The eighth category is the most commonly cited one, the combined CPI, which measures several thousand prices of goods and services on a monthly basis.
In the 10 years before the ACA took effect, the medical CPI inflation rate was as follows:
2000 – 4.29%
2001 – 4.79%
2002 – 5.07%
2003 – 4.47%
2004 – 5.02%
2005 – 4.78%
2006 – 4.14%
2007 – 5.33%
2008 – 4.24%
2009 – 3.21%
In the 10 years after it took effect:
2010 – 3.50%
2011 – 3.06%
2012 – 3.90%
2013 – 3.10%
2014 – 2.38%
2015 – 2.45%
2016 – 3.91%
2017 – 2.43%
2018 – 2.17%
2019 – 3.51%
Medical CPI inflation in the 2% range has not been seen since 1997. Before that, in 1963-64. Three times in the 47 years prior to 2010, and four times in the 10 years after the ACA took effect.
I think all will agree that 2020 was a medical aberration, with an inflationary increase of 4.94% during a pandemic.
While inflation in the overall cost of medical care is an extraordinarily complex subject, is it possible that the ACA has saved American families billions upon billions of dollars, due to lower inflation in overall medical costs? Is it possible that the Supreme Court justices know this? Just a thought! After all, three times the ACA has come up for review and three times a conservative Court has found a way to keep it in place, this time on a 7-2 vote. Each of the three rulings perplexes conservative pundits, who place party before country. Perhaps, the Court, by ruling without ruling, is simply placing country before party.
Courts do many things for many different reasons. Lack of standing is just one method to avoid certain rulings. Decades ago, two DEA agents testified during a motion to suppress in a possession of cocaine case. I left the first one alone, knowing the State would call the second one. On direct examination, the second agent testified to the same facts that the first one had already offered to the court. During cross-examination, using very basic questions, the second agent admitted that he had intentionally lied under oath when filing the complaint affidavit and that he had not informed the prosecutor before the hearing about the lies, so she had brought the wrong case law to argue to the court. The judge took the motion under advisement and several weeks after the hearing, the judge asked the prosecutor whether she planned to appeal his decision to suppress the evidence. If she intended to appeal, he stated he would have to write a detailed order, which would document why he had to find that both officers had lied under oath. After all, when an agent tells a judge point-blank that he lied under oath when initiating the case and that he knew he was lying when he did it, what else can a judge do? Everyone knew such a detailed order would be a career-ending document for both of them. If she elected to forego appeal, he said he would file a simple order granting the motion to suppress, without stating any reasons. The prosecutor told the judge she would not appeal his order and the judge never wrote that the pair had lied under oath. Several defense attorneys criticized me for not insisting on a full finding from the court, arguing that the officers needed to be fired, but my primary concern was representing my client’s interests, not satisfying the desires of other defense attorneys. Besides, being criticized comes with the job. I always tried to be a zealous advocate for my clients, both as a prosecutor and a defense attorney. I remember receiving my first letter lacking a return address, about 30 years ago, after I was interviewed on a radio program for winning a different motion to suppress. The unidentified author, among other more caustic veiled threats, urged me to run for public office so he or she could vote against me. I have read commenters to FlaglerLive posting the same comment. Some things just never change.
Brian says
I just don`t get Rethuglican voters ,can`t they see their party wants to strip them of their health insurance , SS and Medicare , why would you vote for someone that wants to strip you of your life sustaining needs ? A party that refusing to give you a living wage , refuses to rebuild our roads and bridges ,train tracks , have any of you looked at other major cities in other countries , they are beautiful , they have high speed rail systems , they look like futuristic cities in sci fi movies , but they are not , we just live in old shitty crumbling cities that Rethuglicans refuse to fix and rebuild because they are owned by the 1%`ers that want all that money for themselves they could care less about us , all we are here for is to work in their factories , fight their greed wars, and steal our tax money , that is it it`s all them and Rethuglicans want us for , they want us to have nothing , they arm us with weapons turn us against each other and are highly amused when they see us kill each other , they will not change gun laws , just send out their ridiculous thoughts and prayers line , it costs them nothing to say that , because to them we are worth nothing .
Paul says
It’s ironic that Ashley Moody and by association Ron DeSantis continued to try to scupper the ACA, which provides health coverage for millions of Floridians, while simultaneously promoting symbolic legislation to provide immediate care for injured police dogs.
Skibum says
In reading the national news this morning, I was shocked but not surprised to read that there have been 2,000 attempts by the GOP thus far to dismantle the Affordable Care Act since it was passed into law. And yet, despite all of the blather and posturing about their so-called “repeal and replace” pursuit over more than a decade, the GOP has NEVER even once proposed ANY replacement legislation. It was obvious long ago that the reason was they had no replacement plan and only wanted to return to what was in place before in order to placate all of the corporate medical insurers who were getting rich off of the system and the American people. Thank God once again SCOTUS has loudly hammered another nail into this coffin, and hopefully for the last time. While Obamacare is not perfect, it is well established law and every year more and more Americans who weren’t eligible for employer provided health insurance before sign up and realize it’s benefits to them and their families. This was a win for the American people!
David S. says
So glad that the Supreme Court did their thing again and spit in the face of those republicans. Maybe they will finally keep their mouth shut for once.