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Supreme Court to Hear Challenge to ACA

By Jack O'Brien  
   March 02, 2020

The court is expected to hear the case during its fall term and return a decision by June 2021.

The Supreme Court agreed Monday morning to hear United States v. Texas, the lawsuit challenging the constitutionality of the Affordable Care Act (ACA).

The court granted a petition for certiorari filed by a coalition of states led by California Attorney General Xavier Becerra and a petition filed by Texas on the issue of the severability of the individual mandate from the ACA.

In a press statement Monday, Becerra commended the court for agreeing to hear the case.

"Our health is the most precious resource we have—we should all be working to improve healthcare, instead of ripping coverage away from those most in need,” Becerra said. "As Texas and the Trump Administration fight to disrupt our healthcare system and the coverage that millions rely upon, we look forward to making our case in defense of the ACA.  American lives depend upon it."

Meanwhile, Texas Attorney General Ken Paxton issued a statement that the constitutionality of the ACA "must be determined."

"The Fifth Circuit correctly applied existing U.S. Supreme Court precedent when they ruled that the individual mandate itself was unconstitutional," Paxton said. "Without the individual mandate, the entire law becomes unsupportable. The federal government cannot order private citizens to purchase subpar insurance that they don’t want, and I look forward to finally settling the matter before the U.S. Supreme Court."

The court's decision comes over two months after the Fifth Circuit Court of Appeals ruled that the ACA's individual mandate was unconstitutional but remanded the case down to a district court which had previously ruled the entire law was unconstitutional.

Related: Appellate Court Rules ACA Individual Mandate Unconstitutional But Stops Short of Tossing Entirely Law

In mid-February, the court used a private conference to discuss whether to expedite the request for an appeal in United States v. Texas.

The court is expected to hear the case during its fall term and return a decision by June 2021, according to Amy Howe, a reporter for SCOTUSblog.

Healthcare policy observers were quick to opine on the upcoming legal challenge to the landmark healthcare legislation and its implications for the industry.

America’s Health Insurance Plans (AHIP) applauded the court's decision to hear the case, saying it will "remove the continued legal uncertainty that undermines the stability of coverage for nearly 300 million Americans."

"We are confident that the Supreme Court will agree that the district court’s original decision to invalidate the entire ACA was misguided and wrong, and that zeroing out the mandate was never intended to wreak havoc across the entire American healthcare system," Matt Eyles, CEO of AHIP, said in a statement. 

Related: AGs File Petition with SCOTUS for Expedited ACA Review

Nicholas Bagley, a law professor at the University of Michigan, tweeted that the timing of the case could be "huge politically."

"On the eve of the election, Trump won't want public attention drawn to his argument that the courts should end protections for people w/ pre-existing conditions," Bagley said. 

Margaret Murray, CEO of the Association for Community Affiliated Plans (ACAP), issued a statement praising the court's decision to hear the appeal, adding that "the buck stops at the Supreme Court."

"This lawsuit has cast a pall of uncertainty over the future of the individual insurance market," Murray said. "This uncertainty has hindered competition as health plans have waited out substantial uncertainty: legal uncertainty as this and other cases have made their way through the system, political uncertainty as Congress has mounted innumerable failed efforts to repeal the ACA, and substantial policy and regulatory uncertainty from this Administration as they have repeatedly rewritten the business rules for Marketplace plans—sometimes in the middle of the year and in what appears to be an arbitrary manner."

Related: No End in Sight: Courts Unlikely to Resolve ACA Case Before 2020 Election

Marty Lederman, a law professor at Georgetown University Law Center, tweeted that healthcare stakeholders should pay attention to May 15.

"Unless the Court grants extensions (possible, but limited), that'll be the day the Trump Administration files its brief explaining how the POTUS and GOP Congress eliminated coverage for pre-existing conditions (& all other [ACA] reforms)," Lederman said. 

Related: ACA Ruling Dismays Hospitals, as Law's Defenders Look to Supreme Court

Meanwhile, Andy Slavitt, MBA, a former administrator for the Centers for Medicare & Medicaid Services (CMS), tweeted that if the Supreme Court had delayed the case, it would have been sent back to the district court, a move which would have advantaged the Trump administration.

"[President] Trump asked for it to be delayed. He didn’t want this covered during election season and he wanted the opportunity to appoint more Justices," Slavitt said.

Editor's note: This story has been updated with commentary from California Attorney General Xavier Becerra, Texas Attorney General Ken Paxton, and the Association for Community Affiliated Plans.

Jack O'Brien is the finance editor at HealthLeaders, a Simplify Compliance brand.

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