Written by Skyler Shipp (News Writer)
The Affordable Care Act has been a polarizing piece of legislation. On November 10th, the majority conservative Supreme Court heard arguments in the case California v. Texas, in which they could decide to repeal the act. If the ACA is repealed, over 20 million Americans could lose their health insurance (According to CBS). The Supreme Court now holds the future of this act in their hands, but the battle is not quite as simple as it seems.
The ACA was passed in 2010 under the Obama administration to address the high costs of insurance. Through regulation, it aimed to make insurance more affordable for many Americans, protect those with pre-existing conditions, and expand Medicaid, a public health insurance program for low-income families or individuals (Investopedia). It also included an individual mandate, which required people to purchase health insurance or receive a penalty. This mandate and Medicaid expansion were the parts of the ACA that have been the most controversial.
In 2012, a case about the ACA reached the supreme court- National Federation of Independent Business v. Sebelius. The main parts of this act that were challenged were the individual mandate and Medicaid expansion. The individual mandate was upheld by a 5-4 majority, with Chief Justice John Roberts siding with the liberal justices. He argued that since the penalty was based on income and collected by the IRS, it was a tax that was within Congress’s power and therefore constitutional. However, the court found the Medicaid expansion unconstitutional because it withheld existing Medicaid funding from states that did not comply with the expansion. In 2017, Congress voted to set the penalty in the individual mandate at $0 effectively voiding the penalty. It has remained at $0 since.
On Tuesday, November 10th, the Supreme Court meeting mainly discussed a key idea about the law “severability”, which is whether the individual mandate is severable from the rest of the act. In the hearing, the Republicans argued that the individual mandate, even with no fine, serves as a command to purchase health insurance and is unconstitutional. Most importantly, they asserted that the Affordable Care Act included language suggesting the individual mandate was not severable from the act, and therefore the entire act must be struck down. However, some of the Conservative Justices pointed out that the language used by the act is not consistent with traditional severability clauses. The Democrats defending the act argued that the act has remained functional even though the penalty was changed to $0 in 2017, proving that the individual mandate is not necessary and is therefore severable from the act.
Many are extremely worried about this case because it could end with the ACA being struck down, but there are reasons for supporters of the act to be optimistic. Conservative Chief Justice John Roberts defended the severability of the individual mandate saying, “It’s hard for you to argue that Congress intended the entire act to fall if the mandate was struck down.” More surprisingly Justice Brett Kavanaugh, a Trump appointee and one of the court’s more conservative justices, said “This is a fairly straightforward case for severability under our precedents, meaning that we would excise the mandate and leave the rest of the act in place.” Many are concerned about the newest justice, Trump appointee Amy Coney Barret, with SLV student Luke Reason saying, “I feel a little bit worried about Amy Coney Barret, as I feel her appointment was rushed and she seemed to refuse to answer a lot of important information, making her current stances on certain subjects basically unknown to the public.” This case will be important in understanding her stance on certain issues.
With two conservative justices agreeing that the individual mandate is severable, there is now a majority of the court who seem to support keeping most of the ACA intact. This means that the most likely outcome for this case is for the individual mandate to be ruled unconstitutional but still severable from the act. This would not affect anyone’s coverage and allow the main parts of the ACA to remain.
This is a major case for anyone in the US with preexisting conditions because the ACA protects them from being discriminated against in healthcare costs. This decision will also affect anyone who relies on the act to be able to afford healthcare. “I would like to see the courts uphold Obamacare as there is currently no plan set up that would replace it and just getting rid of it would open up so many problems for millions of Americans, especially those with preexisting conditions,” said Luke when asked what he wanted to see happen in this ruling. With the problematic individual mandate and Medicaid expansion gone, the act will hopefully undergo fewer legal battles and continue to keep insurance more affordable. It will probably be a while until we get the final verdict for this case, most likely several months into 2021.