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NAELA News Journal - NAELA News Online

Supreme Court Upholds the Affordable Care Act in 7-2 Ruling

By Erica Asbell, Esq., Senior Public Policy Associate for NAELA
Published July 2021
On June 17, 2021, the Supreme Court issued its opinion on the constitutionality of the Affordable Care Act (ACA) and reversed the lower court ruling that the ACA was unconstitutional. This highly awaited opinion guarantees that tens of millions of Americans will continue to have health coverage, especially in a time where the United States is still recovering from the COVID-19 pandemic. The 7-2 ruling included both Justices Brett Kavanaugh and Amy Coney Barrett, who were appointed during the Trump Administration, as well as Chief Justice John Roberts.

Background of Case and Oral Arguments
Late last year, NAELA had covered oral arguments in this case, California v. Texas, for its members. The case and oral arguments focused on three key issues: 1) standing of Texas and the other states to sue, 2) the constitutionality of the individual mandate, and 3) whether the ACA could stand by severing the individual mandate. For standing, Texas and other states challenging the ACA needed to show that they have suffered an actual injury. With the tax penalty now set at $0, it raised significant questions about whether Texas and the other challenging states have standing. During oral arguments, several Justices raised questions about standing and that there was the possibility of severability under Supreme Court precedent.

ACA Court Decision: Question of Standing
The Supreme Court held that Texas and other states challenging the ACA lacked standing to sue. Early in the majority opinion, which was written by Justice Stephen Breyer, the Justice stated that: “We proceed no further than standing.” Because the tax penalty is now set at $0, there was no way for the plaintiffs to meet the threshold for standing. The Justices concluded that: “The plaintiffs in this suit failed to show a concrete, particularized injury fairly traceable to the defendants’ conduct in enforcing the specific statutory provision they attack as unconstitutional. They have failed to show that they have standing to attack as unconstitutional the Act’s minimum essential coverage provision.” Justices Roberts, Thomas, Sotomayor, Kagan, Kavanaugh, and Barrett joined this opinion, with Justice Thomas filing a concurring opinion. Only conservative Justices Alito and Gorsuch filed a dissenting opinion.

What Happens in the Future with the ACA?
During his presidential campaign and in the months leading up to the Supreme Court decision, President Joe Biden had affirmed his support to ensure that Americans have access to health coverage. This Administration has expressed its intent to build on the ACA when proposing policies that would improve and expand health care coverage. Although any health care policies are likely to be widely debated in this Congress, the upholding of the ACA is one less hurdle towards strengthening health care in the United States. One policy that this Administration is prioritizing is closing the “Medicaid coverage gap” in the 12 states that did not opt in for Medicaid expansion through the ACA. An estimated two million people are in the “coverage gap,” and this Administration is proposing ways to provide incentives to the states that have not yet expanded Medicaid.

NAELA’s Support for ACA and Greater Access to Health Care
NAELA will continue to advocate to protect and expand affordable and comprehensive health care for older adults and people with disabilities. NAELA’s volunteers play a pivotal role in these advocacy efforts.
About the Author
Erica Asbell, Esq., is the NAELA Senior Public Policy Associate.