Supreme Court Considers Constitutional Challenge on the Affordable Care Act
Peter W. Thomas, JD, Principal, Powers Pyles Sutter & Verville, PC
Leela Baggett, JD, Associate, Powers Pyles Sutter & Verville, PC
On November 11, 2020, the U.S. Supreme Court heard its third major case challenging the constitutionality of the Patient Protection and Affordable Care Act (ACA). California v. Texas (Docket No. 19-840), questions whether the entire ACA should be struck down because Congress, in 2017 tax cut legislation, eliminated the tax penalties for failure to comply with the individual insurance mandate, referenced in the ACA text as integral to the law. Without the tax penalty, the argument states, the constitutionality of the law cannot be based on Congress’ power to tax its citizens and, therefore, the entire law must be struck down. The case was brought by a group of Attorneys General from 18 Republican-led states1 and argued by the Texas Solicitor General. In an unusual twist, the U.S. Department of Justice (DOJ) joined the case with Texas, though the federal government typically defends the laws of the United States before the court. However, in this case the DOJ argued that the ACA should be invalidated. As a result, a group of Attorneys General from Democrat-led states2 obtained permission from the court to intervene and defend the law, joined in oral arguments by counsel for the U.S. House of Representatives, another unusual development. History of ACA Challenges Previous challenges to the ACA in 2012 and 2015 resulted in landmark decisions that preserved the sanctity of the law. In National Federation of Independent Business v. Sebelius, the Supreme Court held that the mandate to purchase health insurance under the ACA was constitutional, not under the interstate commerce clause, but under the taxing power afforded to Congress. The case also established that the ACA Medicaid expansion policy was coercive, as written, and that states had to have a meaningful choice in expanding Medicaid without risking the loss of federal matching funds for their existing Medicaid program. The majority opinion was written by Chief Justice John Roberts, considered part of the conservative block of Justices, but who joined with the liberal wing of the Court to produce a 5-4 decision in the case. In 2015, King v. Burwell reached the Supreme Court and, again, the Court decided by a vote of 6-3 to preserve the financial subsidies provided to low income enrollees in the state and federal exchanges (marketplaces), though the text of the ACA appeared to limit subsidies to state exchanges only. Finally, in 2017, the Senate came within one vote of repealing the ACA, but the late Sen. John McCain (R-AZ) cast the deciding vote to maintain the law, dealing a major blow to then President Trump.
1 T he respondents include the states of TX, AL, AR, AZ, FL, GA, IN, KS, LA, MS, MO, NE, ND, SC, SD, TN, UT, and WV, along with two individual plaintiffs living in TX. 2 The petitioners include the states of CA, CO, CT, DE, DC, HI, IL, IA, KY, MA, MI, MN, NV, NC, NJ, NY, OR, RI, VA, VT, and WA.
AMRPA Magazine / December 2020
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