Supreme Court Pulls ACA Constitutionality Case Away From District Court

Texas v. Azar, Texas v. California and California v. Texas

In the high court, the Democratic coalition, led by California, is vying to overturn a December ruling, on Texas et al. v. Azar et al., by the 5th U.S. Circuit Court of Appeals. A divided panel ruled that the individual mandate to purchase health insurance — which the Supreme Court upheld in 2012 as a constitutional tax — was no longer constitutional because Congress in 2017 zeroed out the tax penalty for failure to have insurance.

California Deputy Solicitor General Samuel Siegel represents the Democratic-led states in the petition California et al. v. Texas et al. (Case Number 19-840). Texas and other states have filed a separate action, Texas et al. v. California et al. (Case Number 19-1019). The Supreme Court has now told the parties to submit subsequent filings through the California v. Texas case.

U.S. Solicitor General Noel Francisco and Texas solicitor general Kyle Hawkins urged the justices not to grant review. Francisco said the 5th Circuit did not "definitively resolve any question of practical significance." He and Hawkins argued that the high court should wait for a final decision by the lower courts on the issue of whether the ACA can operate without the individual mandate.

"This court should not allow petitioners to leapfrog lower-court consideration based on their own asserted 'need for certainty,'" Hawkins wrote.

What Could Go Away

If the entire Affordable Care Act is unconstitutional, as argued by the Trump administration's Justice Department and the Republican coalition, the law's insurance coverage would end for an estimated 20 million people, including protection for people with pre-existing conditions, the Medicaid expansion in many states, coverage for young persons up to age 26 on their parents' plans, subsidies for low-income people and a host of other wide-ranging changes.

If the Supreme Court finds that all of the ACA is unconstitutional, that ruling could also have a major effect on many matters unrelated to what members of the general public typically think of as being "Obamacare."

One part of the ACA, for example, is responsible for narrowing the Medicare Part D prescription drug plan "donut hole," or the gap between when routine benefits end and catastrophic benefits begin.

Other parts shape how the federal government subsidizes the physician training programs at teaching hospitals, provide funding for programs that train health care providers who work with the elderly, and govern the reporting of physician quality information.

Other Cases

The justices have agreed to decide two other ACA-related issues this term. In December, the court heard arguments in three consolidated cases contending that the federal government broke a statutory promise to pay insurers in the first three years of health benefit exchanges when their costs exceeded the premiums they collected. Not yet scheduled for arguments are two Pennsylvania cases concerning the Trump administration's expansion of the conscience exception to the contraceptive coverage requirement in the ACA.

— Read Trump Administration Fears 'Chaos' If ACA Provisions Blocked Too Soon, on ThinkAdvisor.

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