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Affordable Care Act survives Supreme Court challenge (again)

Three times Republicans asked the Supreme Court to tear down the Affordable Care Act. Three times the justices said no.
The Supreme Court at sundown in Washington on Nov. 6, 2020.
The Supreme Court at sundown in Washington on Nov. 6, 2020.J. Scott Applewhite / AP file

Twice in recent years, Republican opponents of the Affordable Care Act have asked the Supreme Court to tear down the health care reform law. In both cases, "Obamacare" survived the high court challenges.

For the right, was the third time the charm? Fortunately for the tens of millions of Americans who benefit from the ACA, it was not.

The U.S. Supreme Court ruled 7-2 Thursday that the Affordable Care Act, better known as Obamacare, remains valid, rejecting a claim by a group of conservative states that a recent change to the law made it unconstitutional.... In the decision, Justice Stephen Breyer said the states don't have standing to challenge the individual mandate "because they have not shown a past or future injury fairly traceable to defendants' conduct enforcing the specific statutory provision they attack as unconstitutional."

In California v. Texas, Breyer was joined in the seven-member majority by Justices Roberts, Thomas, Sotomayor, Kagan, Kavanaugh, and Barrett. In the minority were Justices Alito and Gorsuch.

For those keeping score, the Supreme Court first upheld the constitutionality of the ACA nine years ago this month in a 5-4 ruling. Three years later, the justices once again backed "Obamacare" in a 6-3 ruling. Today, was the law's third high court victory.

For those who may need a refresher, at issue is a lawsuit filed by Republican officials in Texas and several other red states -- with the enthusiastic support of the Trump administration -- who argued that the ACA had to be torn down in its entirety because Congress gutted the ACA's individual mandate in late 2017. By Republicans' reasoning, this provision was so integral to the reform law that the nation's health care system can't function without it.

Their argument, of course, was belied by the fact that the Affordable Care Act appears to be working just fine, even after federal GOP lawmakers effectively scrapped the relevant tax provision nearly four years ago.

Nevertheless, Republicans persuaded a far-right judge in Texas to go along with the scheme. The week before Christmas in 2018, U.S. District Judge Reed O'Connor -- a Bush-appointed jurist in Texas -- agreed to strike down the entirety of the Affordable Care Act, root and branch.

Even many conservatives and ACA critics agreed that the ruling was indefensible. Reactions tended to include words and phrases such as "pretty bananas," "embarrassingly bad," and "absurd."

The hope among health care advocates was that the 5th Circuit would hear the appeal, overturn the nonsensical district court ruling, and the matter would be put to rest. That's not what happened: In late 2019, a three-judge appellate panel -- including a Trump nominee -- ruled that the ACA's individual mandate is unconstitutional and sent the case back to the lower court.

In effect, the 5th Circuit tasked O'Connor, the far-right judge whose ruling was widely panned, to reconsider the case after they rejected the ACA's individual mandate. The point, evidently, was for him to evaluate whether elements of the law could remain intact, or whether the entirety of the ACA system -- every benefit, every protection, every safeguard, etc. -- should be destroyed.

The Supreme Court then intervened and took up the case. Seven justices concluded that the case shouldn't even exist because Texas couldn't credibly claim to have been injured by a $0 tax penalty.

The high court was expected to rule on substantive questions -- Is the zeroed-out individual mandate unconstitutional? If so, can it be "severed" from the rest of the ACA? -- but instead the court did not address the case on the merits. That said, given what we saw during oral arguments, Republicans were likely to lose on that front, too.

So what happens now? For one thing, the ACA keeps on ticking and the families who rely on it can breathe a sigh of relief. For another, Democrats can continue to try to built on the ACA foundation, confident in the knowledge that it's not going anywhere, at least not anytime soon.

As for the law's Republican opponents, they could conceivably try again to take ACA benefits from tens of millions of Americans, but after three Supreme Court defeats in three tries, Republicans really ought to find a new hobby.