Supreme Court upholds Affordable Care Act

The US Supreme Court has once again upheld the constitutionality of the Affordable Care Act (ACA) but did not close the door on future challenges.

In a 7 to 2 ruling, the High Court ruled that Texas lacked standing in its challenge to the individual mandate. In the technical ruling the court failed to address the underlying issues of the suit.

Justice Stephen Breyer wrote the decision for the majority, while Justices Samuel Alito and Neil Gorsuch dissented.

The opinion brings the latest high-profile challenge to the law to an end.

“Today’s decision by the U.S. Supreme Court is a victory for patients and for the gains in health care coverage achieved through the Affordable Care Act (ACA),” American Medical Association (AMA) President Gerald E. Harmon, MD, said in a statement. “The American Medical Association is pleased that the high court rejected the challenge to the ACA, thereby upholding critical patient protections that are improving the lives and health of millions of Americans, particularly amid a global pandemic.”

The law was challenged by 18 states, led by Texas. Those states the court to rule that Obamacare's requirement for nearly all Americans to obtain health insurance or pay an income tax penalty — known as the individual mandate — is unconstitutional.

For that reason, they said, the entire law must be scrapped.

The individual mandate was ruled unconstitutional in a 2-1 decision by the U.S. Court of Appeals for the Fifth Circuit in New Orleans, the majority chose to return the case to Judge Reed O’Connor in the Federal District Court in Fort Worth, Texas, to determine whether the mandate can be severed from the rest of the law.

In 2018, O’Connor ruled the ACA was unconstitutional because of how central the mandate was to the law, according to a report from The New York Times. 

O’Connor’s previous ruling was based on Congress’s belief when it enacted the ACA that the individual mandate was a key element to the law that could not be severed from it.

He found the mandate unconstitutional because a 2012 Supreme Court decision upheld the mandate, saying that it fell under Congress’ powers over taxation, according to the Times.

When the tax penalty was eliminated in 2017, 20 state attorneys general, the plaintiffs in the case, argued that defense of the law was no longer effective and that the rest of the law should be invalidated along with it.

The Department of Justice refused to defend the law, and later joined the plaintiffs in arguing against the law, according to the Times.

The Fifth Circuit decision was appealed, which brought the case to the U.S. Supreme Court where the health insurance coverage of about 23 million Americans hung in the balance, according to The Times.