Courts/First Amendment

ACA Survives SCOTUS Scrutiny, Latest in “String of Victories”

June 17, 2021 – Today the U.S. Supreme Court dismissed a lawsuit claiming that the Affordable Care Act (ACA) is unconstitutional, leaving it as the law of the land. The Court ruled that the plaintiffs—a group of Republican attorneys general and two individuals—do not have legal standing to sue.

According to Coalition for Healthcare Communication Executive Director Jon Bigelow, this ruling is the latest in a string of “victories” for the ACA in 2021, which include President Joe Biden’s executive orders and the American Rescue Plan legislation that together increased ACA subsidies, lowered the income threshold for eligibility, created a special open enrollment period, increased the marketing budget, and enhanced the financial incentives for “hold-out” states to extend health coverage through Medicaid. As a result, a record 31 million Americans now have coverage under the ACA, according to a June 5 news release from HHS.

“Today’s decision means that Congress and the President dodge a crisis: what would have been an immediate need to agree on fixing or replacing the ACA, or otherwise allow those 31 million Americans to lose their health insurance,” Bigelow noted, adding that “ACA provisions affecting employer-based insurance plans—such as covering pre-existing conditions, capping lifetime expenses, and allowing children to stay on parents’ policies through age 26—remain in place. So do the Sunshine Act and the pathway for approving biosimilars, both of which were enacted as part of the ACA.”

The Supreme Court previously affirmed the ACA’s constitutionality in major cases in 2012 and 2015, in 5-4 decisions joined by Chief Justice John Roberts and four liberal justices. The cases revolved around the law’s “individual mandate” requiring that Americans have health insurance coverage or pay a tax penalty.

In today’s decision, the Court found that the plaintiffs had “failed to show a concrete, particularized injury fairly traceable to … enforcing the specific statutory provision they attack as unconstitutional,” according to the majority opinion written by Justice Stephen Breyer. Others voting in the 7-2 majority included Chief Justice Roberts and Justices Kavanaugh, Amy Coney Barrett, Elena Kagan, Sonia Sotomayor, and Clarence Thomas.

By focusing on legal standing, the Supreme Court avoided addressing the merits of the arguments about constitutionality. “The practical result is that the ACA was left standing, and it appears highly unlikely there will be any further serious legal attempt to overturn it,” Bigelow said.