In a 7-2 decision, the Supreme Court has rejected a constitutional challenge to the Affordable Care Act due to lack of standing, upholding the Obama-era health care law.
The ruling is the third time the nation's highest court has preserved the 2010 law, colloquially referred to as "Obamacare."
The justices left the entire law intact Thursday, ruling that Texas, other Republican-led states and two individuals had no right to bring their lawsuit in federal court.
Republicans pressed their argument to invalidate the whole law even though congressional efforts to rip out the entire law “root and branch,” in Senate GOP Leader Mitch McConnell’s words, have failed. The closest they came was in July 2017 when Arizona Sen. John McCain, who died the following year, delivered a dramatic thumbs-down vote to a repeal effort by fellow Republicans.
Chief Justice John Roberts and Justices Clarence Thomas, Amy Coney Barrett and Brett Kavanaugh sided with the high court's liberal justices in the ruling.
Justice Breyer wrote for the court that the states and people who filed a federal lawsuit “have failed to show that they have standing to attack as unconstitutional the Act’s minimum essential coverage provision.”
“For these reasons, we conclude that the plaintiffs in this suit failed to show a concrete, particularized injury fairly traceable to the defendants’ conduct in enforcing the spe- cific statutory provision they attack as unconstitutional,” the ruling read.
Justices Samuel Alito and Neil Gorsuch dissented.
"Today’s decision is the third installment in our epic Affordable Care Act trilogy, and it follows the same pattern as installments one and two," Alito wrote in the dissent, joined by Gorsuch. "In all three episodes, with the Affordable Care Act facing a serious threat, the Court has pulled off an improbable rescue."
The law’s major provisions include protections for people with pre-existing health conditions, a range of no-cost preventive services and the expansion of the Medicaid program that insures lower-income people, including those who work in jobs that don’t pay much or provide health insurance.
Also left in place is the law’s now-toothless requirement that people have health insurance or pay a penalty. Congress rendered that provision irrelevant in 2017 when it reduced the penalty to zero.
The elimination of the penalty had become the hook that Texas and other Republican-led states, as well as the Trump administration, used to attack the entire law. They argued that without the mandate, a pillar of the law when it was passed in 2010, the rest of the law should fall, too.
And with a more conservative Supreme Court that includes three Trump appointees, opponents of “Obamacare” hoped a majority of the justices would finally kill off the law they have been fighting against for more than a decade.
Advocates and proponents of the measure celebrated the court's decision, including President Joe Biden who celebrated the fact that the ACA "remains the law of the land."
"Today’s U.S. Supreme Court decision is a major victory for all Americans benefitting from this groundbreaking and life-changing law," Biden wrote. "It is a victory for more than 130 million Americans with pre-existing conditions and millions more who were in immediate danger of losing their health care in the midst of a once-in-a-century pandemic."
"It is a victory for every American who, prior to the Affordable Care Act, stayed up at night staring at the ceiling, wondering whether they would lose everything if they or a loved one got sick," Biden continued. "Because of this law, they don’t have to worry about being denied coverage due to a pre-existing condition like diabetes or watching their coverage being capped during a cancer treatment. Because of the law, they are able to get free preventive screenings that can save their lives and improve their health."
Biden pledged to work with Congress "to build on this law so that the American people will continue to have access to quality and affordable health care."
"Once again, the Supreme Court has made clear that the landmark Affordable Care Act is the law of the land," Health and Human Services Secretary Xavier Becerra said in a statement. "Today’s ruling is a victory for all Americans, especially people with a pre-existing condition or anyone who was worried they could be forced to choose between their health and making ends meet. Health care should be a right -- not a privilege -- just for the healthy and wealthy."
"Today’s decision means that all Americans continue to have a right to access affordable care, free of discrimination," he continued. "More than 133 million people with pre-existing conditions, like cancer, asthma or diabetes, can have peace of mind knowing that the health protections they rely on are safe. Women who need access to birth control, life-saving maternity care and preventive care can rest easy, knowing that their care is protected and covered. Seniors and people with disabilities can breathe easy knowing their health protections will continue. Individuals who have faced discrimination can continue accessing care without fear. And people relying on Medicaid and Medicare should know these programs are stronger than ever."
"As a Member of Congress, I helped draft and pass the ACA," Becerra concluded. "As the Attorney General of California, I took this case all the way to the Supreme Court. And now, as Secretary, I will continue to stand up and stand with you to protect access to affordable health care."
"The Affordable Care Act has won," Senate Majority Leader Chuck Schumer said Thursday on the Senate floor. "The Supreme Court has just ruled: the ACA is here to stay. Ad now we're going to try make it bigger and better, establish once and for all affordable healthcare as a basic right of every American citizen."
Polls show that the 2010 health care law grew in popularity as it endured the heaviest assault. In December 2016, just before Obama left office and Trump swept in calling the ACA a “disaster,” 46% of Americans had an unfavorable view of the law, while 43% approved, according to the Kaiser Family Foundation tracking poll. Those ratings flipped and by February of this year 54% had a favorable view, while disapproval had fallen to 39% in the same ongoing poll.
The health law is now undergoing an expansion under President Joe Biden, who sees it as the foundation for moving the U.S. to coverage for all. His giant COVID-19 relief bill significantly increased subsidies for private health plans offered through the ACA’s insurance markets, while also dangling higher federal payments before the dozen states that have declined the law’s Medicaid expansion. About 1 million people have signed up with HealthCare.gov since Biden reopened enrollment amid high levels of COVID cases earlier this year.
The administration says an estimated 31 million people are covered because of the law, most through its combination of Medicaid expansion and marketplace plans. But its most popular benefit is protection for people with pre-existing medical conditions. They cannot be turned down for coverage on account of health problems, or charged a higher premium. While those covered under employer plans already had such protections, “Obamacare” guaranteed them for people buying individual policies.
Another hugely popular benefit allowed young adults to remain on their parents’ health insurance until they turn 26. Before the law, going without medical coverage was akin to a rite of passage for people in their 20s getting a start in the world.
Because of the ACA, most privately insured women receive birth control free of charge. It’s considered a preventive benefit covered at no additional cost to the patient. So are routine screenings for cancer and other conditions.
The Associated Press contributed to this report.