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U.S. Supreme Court to hear ACA challenge next week

November 5, 2020
Keith A. Reynolds
Keith A. Reynolds

While the world watches the presidential election, the fate of the ACA will be in the High Court’s hands a week later.

All eyes may be on the general election, the U.S. Supreme Court is gearing up to hear a case which will decide the fate of millions of Americans’ health insurance.

The justices will begin hearing oral arguments on the Trump administration’s possibly last attempt to have the Affordable Care Act (ACA) dismantled; a priority of the Republican party since its inception in 2010.

Hear Medical Economics Senior Editor Jeffrey Bendix ask Christine Eibner, Ph.D., a Rand Corp. analyst what a ruling against the ACA would mean in an episode of Off the Chart with Medical Economics podcast.​

As previously reported, the case rests on a lower court’s ruling that the individual mandate, which required citizens to buy health insurance or face a tax penalty, was ruled unconstitutional by Judge Reed O’Connor in the Federal District Court in Fort Worth, Texas, in 2018. His ruling actually attempted to invalidate the entire law due to a 2012 Supreme Court decision on the ACA which upheld the mandate saying that it fell under Congress’ taxation powers.

The case was appealed, and at the beginning of the year the U.S. Court of Appeals for the Fifth Circuit in New Orleans released a 2-1 decision to return case back to O’Connor to determine whether the mandate could be severed from the rest of the law.

The suit was filed by 20 state attorneys general after the tax penalty was essentially eliminated in 2017 by Republican majorities in both houses of Congress. The filings argue that defense of the ACA 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 a report from The New York Times.​

Repealing and replacing the ACA was a major promise of President Donald J. Trump during the 2016 election. Despite his failure to do so with Republican majorities in both houses of Congress at the beginning of his term, Trump has continued to promise supporters that it will happen, and once the law is struck down it would be replaced with a better plan. After claiming multiple times this new plan would be released, nothing has been made public except for an executive order saying that patients with pre-existing conditions would not be denied healthcare. This is already a provision of the ACA.

His opponent, Joe R. Biden’s campaign website says that, if elected, his healthcare policy would build on the ACA.

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