Supreme Court Again Upholds Affordable Care Act

The high court issued a 7-2 ruling against the latest challenge to the law on Thursday.

The Affordable Care Act has been upheld by the Supreme Court three times now.
The Affordable Care Act has been upheld by the Supreme Court three times now. (photo: Jaroslav74/Shutterstock)

The Supreme Court once again upheld the Affordable Care Act, in a 7-2 ruling against the latest challenge to the law on Thursday.

In the majority opinion authored by Justice Stephen Breyer, the court ruled that the state of Texas, in leading the case against the Affordable Care Act, “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,” Breyer wrote. The court vacated the 5th Circuit’s judgment on standing and remanded the case to the circuit court to dismiss. 

Breyer was joined in his opinion by Chief Justice John Roberts and Justices Amy Coney Barrett, Elena Kagan, Brett Kavanaugh, Sonia Sotomayor and Clarence Thomas. Additionally, Thomas filed a concurring opinion. 

Justice Samuel Alito wrote the dissenting opinion and was joined by Justice Neil Gorsuch. 

In the case, the Supreme Court was asked to decide if the Affordable Care Act should be struck down if its “individual mandate” was effectively nullified by Congress in 2017. In 2017, Congress changed the penalty for not complying with the mandate to $0. 

The mandate that every American have health insurance, or face a financial penalty, was seen as critical to the law’s implementation and guarantee of affordable health coverage for all. While the fine was reduced to nothing, the language of the individual mandate remained in the law. 

Texas, along with more than a dozen other states, sued, claiming that the mandate was unconstitutional without a fine to enforce it and was also not severable from the rest of the law. Thus, Texas argued that the law must be thrown out as well. California and other states eventually intervened to defend the law’s constitutionality.

President Joe Biden, who was vice president when the law was passed, called the ruling on Thursday, “a big win for the American people” and encouraged people to “sign up for quality, affordable health care.” 

“With millions of people relying on the Affordable Care Act for coverage, it remains, as ever, a BFD,” said Biden, referring to his hot-mic comment in 2010 that the bill was a “big [expletive] deal.”

Thursday’s ruling marks the third time the Supreme Court has upheld the Affordable Care Act as constitutional. 

In 2012, Chief Justice Roberts authored the majority opinion that upheld the constitutionality of the law’s individual mandate. The high court ruled that the mandate’s penalty for non-compliance was a tax, and thus a lawful requirement of Congress to make on Americans.

Three years later, in 2015, the Supreme Court ruled 6-3 in the case King v. Burwell that the law’s subsidies and tax credits could be made available to people who purchased health-insurance coverage on a federal, rather than a state, exchange. 

The U.S. bishops’ conference supported the law’s goal of expanded health coverage, but ultimately opposed its passage for several reasons, including that it “makes new and disturbing changes in federal policy on abortion and conscience rights.” The conference warned about funding of abortions in subsidized health plans under the law. 

Included in the law was a mandate for preventive services, which the Obama administration eventually interpreted to include the full range of Food and Drug Administration-approved contraceptives, sterilizations and abortifacients. That mandate for employer coverage was challenged in court by Catholic dioceses and the Little Sisters of the Poor, who won their second Supreme Court case regarding the mandate last July.

Oscar Wergeland, “Service in a German Village Church,” ca. 1880

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