It all depends on whether the court rules the individual mandate is constitutional or not. If it is, the fight ends there with the law left intact. But the justices could sidestep those questions altogether if they decide neither the states led by Texas nor the individuals that sued suffered the necessary injury for the district court to hear the dispute to begin with.
This is the second time a broad constitutional challenge to the Affordable Care Act has reached the high court. In a case, known as National Federation of Independent Business v. The court said it was unconstitutional to threaten to withhold federal funding to force states to expand Medicaid, but said that constitutional defect was remedied by prohibiting the Health and Human Services secretary from the pulling the purse strings on states that refuse.
The other provisions of the ACA are not affected, the court said. Based on the oral arguments, the precedent in NFIB v. The court heard arguments in the case on Nov. But the delay could signal the court is divided on one or more issues in the case.
The court's conservatives seemed more amenable to the claim from red states and the Justice Department that the law's challengers had been harmed. Roberts noted that if Congress passed a law requiring everyone to mow their lawn once a week, even if there was no penalty, there "will certainly be injury" to those who didn't comply. Justice Clarence Thomas said that such a law could still have a "chilling effect. A ruling siding with the red states by invalidating the individual mandate, but with the blue states by allowing the bulk of the Affordable Care Act to remain standing, would represent a win for Democrats.
Health-care activists said that if the Supreme Court struck down the Affordable Care Act, more than 20 million people could lose their insurance. The dispute, which was argued in the shadow of last week's presidential election, was a central focus of Democrats during the confirmation hearings for Justice Amy Coney Barrett last month.
After the late Justice Ruth Bader Ginsburg, a liberal, died in September, Democrats sought to turn the fight for her replacement, Barrett, into a referendum on the law. In that regard, Barrett's questioning on Tuesday was anticlimactic, as it didn't provide much insight into her thinking about the legal issues. The case had also become a political flash point in the race between Trump and President-elect Joe Biden, who have sketched out vastly different visions for the future of American health care.
Trump pushed to gut the Affordable Care Act, while Biden's agenda calls for building on the law, which the former vice president played a role in shepherding through Congress in the first place. The political stakes were amplified by the pandemic, which has killed more than , in the U. Efforts to contain the pandemic also caused a devastating recession, which has resulted in millions losing their health-care coverage. She noted that given Trump's attacks on the federal judiciary, the chief justice has had to project an air of neutrality more than previous leaders of the court.
Ahead of the case coming to the Supreme Court, two lower courts sided with Texas, including the 5th U. The answer is complicated, as control of the Senate most likely hangs on two runoff elections in Georgia in January.
Or if the Supreme Court did strike down the law with Democrats in control of both houses of Congress and the White House, they could use the decision as an excuse to push for broader health care reform. But if Republicans maintain control of the Senate, none of those fixes seem likely to happen, leaving the health care system in real jeopardy.
In other words, a world in which the entire ACA is overturned by the time the current Supreme Court term ends in June seems somewhat unlikely, but understanding the risks of that scenario is important.
The ACA has grown increasingly popular since Obama left office, and even a majority 66 percent of Republicans want to maintain its protections on people with preexisting conditions, according to an October poll by the Kaiser Family Foundation.
So, as the justices hear oral arguments today, they may not be thinking only about the legal issues in the case — but about what might happen to the court as an institution if a popular health care law were upended by a handful of unelected judges in the middle of a pandemic. Footnotes Led by Texas, these states have either Republican governors or attorneys general.
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