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Supreme Court tosses out major Obamacare challenge

Affordable Care Act survives its third challenge at the high court

Activists democstrated in support of the 2010 health care law at the Supreme Court during the confirmation process for Justice Amy Coney Barrett on Oct. 14, 2020.
Activists democstrated in support of the 2010 health care law at the Supreme Court during the confirmation process for Justice Amy Coney Barrett on Oct. 14, 2020. (Tom Williams/CQ Roll Call file photo)

The 2010 health care law survived its third major Supreme Court challenge Thursday, in a ruling that found that the coalition of Republican-led states seeking to strike down the entire statute did not have the legal right to bring the lawsuit in the first place.

That 7-2 decision, written by Justice Stephen G. Breyer, means the court did not address legal questions about whether the law, known as the Affordable Care Act, or Obamacare, is invalid because it no longer has a penalty for most Americans who don’t get health coverage.

“We proceed no further than standing,” Breyer wrote, because the challengers did not demonstrate that additional costs they would incur are “fairly traceable” to the “allegedly unlawful conduct” of which they complain.

“They have failed to show that they have standing to attack as unconstitutional the Act’s minimum essential coverage provision,” Breyer wrote.

The decision will dismiss the case, which avoids the scenarios that Democratic members of Congress warned about if the whole law fell, such as 23 million people kicked off their insurance, the end of protections for people with preexisting conditions and chaos in the health care sector.

The decision turns down the political heat on the Supreme Court — at least in one major controversial area. Justices from both sides of the ideological spectrum joined a majority opinion authored by a liberal justice. And that opinion rested on legal terms that avoided discussions about policy.

Democrats and liberal advocacy groups, which warn the 6-3 conservative majority will make major decisions that harm Americans, will now focus to two cases that the court will hear next term on abortion and gun rights.

A small group of Democrats has introduced legislation to add justices to the Supreme Court, but Democratic leaders in Congress have said they want to wait for results from President Joe Biden’s commission to study potential court overhauls.

The lawsuit to wipe out Obamacare also became central to the pitched confirmation fight over Justice Amy Coney Barrett in the heat of the 2020 presidential election, with Democrats warning that President Donald Trump’s appointees would look to strike down President Barack Obama’s signature law.

Barrett joined the majority in the ruling, along with Chief Justice John G. Roberts Jr. and Justices Clarence Thomas, Sonia Sotomayor, Elena Kagan and Brett M. Kavanaugh, who is also a Trump appointee.

Justice Samuel A. Alito Jr. wrote a dissent, joined by Justice Neil M. Gorsuch, in which he said the Supreme Court for the third time “has pulled off an improbable rescue.”

“No one can fail to be impressed by the lengths to which this Court has been willing to go to defend the ACA against all threats,” Alito wrote, alluding to holdings in previous Supreme Court challenges.

“A penalty is a tax. The United States is a State. And 18 States who bear costly burdens under the ACA cannot even get a foot in the door to raise a constitutional challenge,” Alito wrote. “So a tax that does not tax is allowed to stand and support one of the biggest Government programs in our Nation’s history.”

The case started after Republicans’ 2017 tax overhaul law eliminated the health care law’s penalty for most Americans who don’t get health coverage. The 18 Republican-led states that filed the challenge, as well as the Trump administration, argued that made the mandate to buy insurance unconstitutional, and that the mandate is so essential to the rest of the law that, in turn, the remainder of the law “must also fall.”

But the justices never got to that argument.

Breyer, for the majority, wrote that the states failed to show that the individual mandate, when it does not have a penalty, will cost them money by leading more individuals to enroll in state-operated or state-sponsored insurance programs such as Medicaid or the Children’s Health Insurance Program.

And Breyer wrote that other costs to the state come from provisions in the law that operate separately from the individual mandate.

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