WASHINGTON – The Supreme Court will hear arguments Tuesday morning in connection with the third major challenge to the Affordable Care Act, the sprawling 2010 healthcare law that is President Barack Obama’s defining national legacy.
Tens of millions of Americans have obtained insurance coverage under the law, which includes popular provisions on guaranteed coverage for pre-existing medical conditions, emergency care, prescription drugs, and maternity care. . Republican state officials, backed by the Trump administration, say a key provision of the law is unconstitutional, and that means the whole law must fall.
The law has survived two previous challenges to the Supreme Court. In 2012, the court upheld the law’s requirement that most Americans obtain insurance or pay a penalty – the “individual warrant”. The vote was 5 to 4, with Chief Justice John G. Roberts Jr. drafting the dominant view that the mandate was authorized by the power of Congress to assess taxes. He was joined by what was then the liberal wing of four members of the court.
In 2015, the court said the federal government could provide nationwide tax subsidies to help the poor and middle classes buy health insurance, dismissing the argument that the subsidies were only available in the provinces. States that had created markets, called exchanges, to allow people who lack insurance to purchase individual health plans. A decision to the contrary would have wreaked havoc on the insurance markets and undermined the law. The vote was 6 to 3, with the four Liberals, Chief Justice and Justice Anthony M. Kennedy, who retired in 2018, in the majority.
Since the last major challenge, three new judges have joined the tribunal, all appointed by President Trump. One of them, Justice Amy Coney Barrett, has publicly criticized the earlier decisions.
In a 2017 law review article, she questioned the Chief Justice’s 2012 opinion. “Chief Justice Roberts took the Affordable Care Act beyond its plausible meaning to save the law,” Justice Barrett wrote.
In an interview after the 2015 ruling, she said, “I think dissent has the best of the legal argument.”
“That’s not to say the outcome isn’t better,” Judge Barrett said at the time. “It is clearly a good result that these millions of Americans do not lose their tax subsidies.”
The new case, California v. Texas, No. 19-840, was brought by Republican officials who said the warrant became unconstitutional after Congress in 2017 overturned the penalty for failing to obtain health insurance because it could no longer be justified as a tax. .
They went on to say that the warrant was a crucial feature of the law, which means all other parts of it should be deleted.
The challenge has largely succeeded in the lower courts. A Texas federal judge ruled that the entire law was invalid, but he postponed the effects of his ruling until the case can be appealed. In December, the United States Court of Appeals for the Fifth Circuit in New Orleans agreed the warrant was unconstitutional but declined to rule on the fate of the rest of the health bill, asking the lower court to reconsider the matter in more detail. .
Democratic States and the House, which intervened in the case to defend the health law, asked the Supreme Court to intervene, saying a swift ruling was needed to remove the uncertainty caused by the decisions of the lower courts.
Defenders of the law are hoping the Republican challengers can’t turn the table on three distinct legal arguments they would need to win: that they suffered the kind of harm that gives them standing to sue; whereas reducing the tax penalty to zero has made the individual mandate unconstitutional; and that the rest of the law cannot hold without the individual mandate.
Republicans also face the challenge of the enormous practical effects of overturning the law. That would increase the ranks of uninsured people in the United States by more than 20 million people – an increase of almost 70% – according to new estimates from the Urban Institute.
The biggest loss of coverage would be among low-income adults who became eligible for Medicaid under the law after all but a dozen states expanded the program to include them. But millions of people would also lose private insurance, including young adults who were legally allowed to stay on their parents’ plans until the age of 26, and families whose incomes were small enough to qualify. grants under the law that help them pay their monthly premiums.
Tuesday’s arguments, which will be heard by telephone, are scheduled for 80 minutes but will likely last two hours or more. Michael J. Mongan, the Solicitor General of California, representing a coalition of liberal-leaning states, will defend the law; Texas Solicitor General Kyle D. Hawkins, representing a coalition of conservative-leaning states, will urge judges to overturn it.
Two other lawyers will also appear: Jeffrey B. Wall, the acting U.S. solicitor general, will advocate for the Trump administration in support of Texas. And Donald B. Verrilli Jr., who successfully defended the law in 2012 as solicitor general in the Obama administration, will be the House advocate for California.