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Yesterday,
the Affordable Care Act (ACA) nabbed its third "You may pass Go" card
from the Supreme Court. In a 7–2 vote, justices ruled that Texas and 17
other Republican-led states don't have the legal standing to challenge the law in federal court.
- The
ACA, aka "Obamacare," is a controversial healthcare bill enacted in
2010. It's known for adding protections for individuals with preexisting
conditions, allowing young adults to remain on their parents' plan
until age 26, and making preventative services (including birth control
on private plans) free.
With their
6–3 majority on the court, some conservatives hoped this case might
finally find the fatal chink in the ACA's legal armor. Although they
fell short again, each major legal challenge threatens serious
disruption to the healthcare industry and the 31+ million Americans who
get their insurance through the ACA.
What they were fighting about
The ACA's
most controversial measure, the individual mandate, required Americans
to pay a tax penalty if they didn't have health insurance. It was made
irrelevant in 2017 when a Republican-led Congress reduced that penalty
to $0.
For their
case, Republican state officials argued that a zeroed-out mandate is
unconstitutional and the entire ACA should go. The court said the
plaintiffs couldn't prove the law had hurt them, but it did not rule on whether the mandate is unconstitutional.
Even if they
haven’t succeeded in overturning the entire law, Republicans aren't
giving up on challenging parts of it. Another lawsuit is winding its way through federal courts over the ACA’s preventative care coverage.
Zoom out
Although the
ACA's popularity is at a record high, only 54% of Americans view the
healthcare law favorably, according to the Kaiser Family Foundation.
Premiums have fallen the last three years, per the Urban Institute, but
the ACA continues to face criticism for high out-of-pocket costs.
President
Biden plans to build off his old boss's signature legislative
achievement. In March's Covid relief package, Biden approved higher
federal subsidies for private health plans offered through the ACA and
larger federal Medicaid payments for states that expand insurance
coverage to more lower-income adults.
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