U.S. Supreme Court to Consider Affordable Care Act . . . Again

The U.S. Supreme Court announced on March 2 that it will review a ruling by U.S. 5th Circuit Court of Appeals regarding the Affordable Care Act (ACA). The health care reform law signed into law by President Barack Obama in 2010 has been reviewed by the court twice in the past. The latest request to consider the individual mandate provision of the ACA came from an appeal by 20 state attorneys general of a lower court ruling that declared it unconstitutional.

Right now, it’s not known for sure when the Supreme Court will hear oral arguments. Health and law experts forecast legal briefs this summer, followed by a hearing after the new court term begins in October. A ruling is not expected prior to the November 2020 election, which could solidify the ACA as a presidential campaign issue. If the court follows its pattern, after a fall hearing, a decision could be announced in the spring of 2021.

In January 2020, justices on the Supreme Court declined a request by the same attorneys general to expedite a hearing on Texas v. California and the 5th Circuit ruling in 2019. Those supporting the ACA argued it was too important of an issue to be decided in a lower case. By pushing for an expedited review, they were hoping for a decision before the court takes its usual recess in late June – and before the fall election.

The earlier filing by the attorneys general said, “The lower court’s actions have created uncertainty about the future of the entire Affordable Care Act, and that uncertainty threatens adverse consequences for our nation’s health care system, including for patients, doctors, insurers, and state and local governments.”

The U.S. Supreme Court has twice upheld major provisions of the ACA, including a 2012 ruling in which Chief Justice John Roberts joined with the court’s four liberal justices. Richard Garnett, a law professor at The University of Notre Dame, told the New York Times he sees the high court’s decision to intervene now, and not wait, as evidence “the justices are skeptical about the challengers’ sweeping arguments that the entire Act is unconstitutional.”

Efforts to overturn the ACA failed numerous times while Republicans held the majority in the House of Representatives. Congress did manage to reduce the ACA’s individual mandate penalty for not having health coverage to zero, as part of the 2017 Tax Cuts and Jobs Act.

That was part of the argument made by the Texas judge in 2018 in declaring the ACA unconstitutional. Texas district court judge Reed O’Connor said because Congress removed the ACA tax penalty, the requirement that people have health insurance “can no longer be sustained as an exercise of Congress’s tax power.” That ruling was appealed to the U.S. Court of Appeals in New Orleans, which considers appeals from district courts in Texas, Louisiana, and Mississippi. In the December 2019 ruling, a split panel of the 5th Circuit ordered the Texas court to rehear the matter. The expedited hearing request to the Supreme Court followed.

In its decision this month to hear arguments on the 5th Circuit Court ruling, justices granted two different appeals – putting the insurance mandate and the validity of the entire health care law back in front of the Supreme Court for the first time since 2015.

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