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A few weeks ago, the Supreme Court announced it would hear a challenge on the Affordable Care Act (ACA), the third of its kind. While the Court did not say exactly when it would hear California v. Texas, arguments are expected to be held in the fall and a decision will be made before the end of June 2021.

California v. Texas is the latest incarnation of Texas v. United States, the case filed by 20 Republican state officials and two individuals in 2017. In Texas v. United States, state officials and the Trump administration argued that when Congress zeroed the individual mandate penalty, Congress rendered the entire law unconstitutional.

A federal district court judge agreed, declaring the ACA unconstitutional. The judge, however, postponed the effect of his ruling until the case could be appealed, allowing the law to remain in place.

An appeals court then reviewed the case and agreed the mandate was unconstitutional but sent the case back to the lower court to reconsider the remainder of the law. Severability–the idea that if some terms of a contract are held to be illegal, the remainder of the law should apply–was the heart of the debate for both courts.

Democratic state officials and the House–unsatisfied with the appeals court’s decision–then appealed the case to the Supreme Court, requesting the court to fast-track the hearing to have a decision by June 2020, given the high stakes of the case. They argued that because part of a federal law had been determined by some to be unconstitutional, a Supreme Court hearing was warranted. They wanted the court to address three issues:

  1. Do the Republican state officials and two individuals have standing to challenge the individual mandate?
  2. Is a zeroed-out individual mandate unconstitutional?
  3. If a zeroed-out individual mandate is unconstitutional, is the remainder of the ACA severable?

The Supreme Court declined the expedited hearing request, so the Democratic officials and the House asked the court to review the case according to regular schedule. On February 28, agreed to grant the Democratic officials and the House’s petition and hear the case.

The first two times the Supreme Court heard cases on the ACA, it left the law largely unscathed. In 2012, the court upheld the individual mandate, asserting it was authorized by Congress’s power to tax. In 2015, the court said the federal government could provide nation-wide tax subsidies to help low-income and middle-income citizens afford insurance.

The ACA has become popular with Americans of varying political gradients. According to the July 2019 Kaiser Family Foundation (KFF) Health Tracking poll, 72% of the public thinks it is very important for the prohibition against health insurance companies from denying coverage for people with pre-existing conditions to be kept in place if the ACA is declared unconstitutional. In addition, a 2020 KFF poll found that 55% of the public supported the law. The poll also found that repealing the law was no longer the top healthcare issue for Republican voters.



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