What makes the affordable care act unconstitutional

After Democratic victories in the mid-term elections, two of these states, Wisconsin and Maine, withdrew from the case in early , leaving 18 states challenging the ACA on appeal Figure 1.

Texas at the Supreme Court. Two individuals joined the lawsuit in the trial court in April , as plaintiffs challenging the ACA. The federal government took the position that these provisions cannot function effectively without the individual mandate but the rest of the ACA should be allowed to survive. Notably, the federal government changed its position while the case was on appeal at the 5 th Circuit Figure 2.

Next, the federal government raised new arguments about the scope of relief that the court should grant, asserting that the federal government should be enjoined from enforcing only the ACA provisions that injure the plaintiffs.

The federal government is asking the Supreme Court to prohibit it from enforcing only the ACA provisions that are found to harm the individual plaintiffs. Even though the federal government is arguing that the entire ACA should be found invalid because the individual mandate is no longer constitutional and cannot be severed from the rest of the law , the federal government does not want the Court to necessarily prevent it from still enforcing parts of the law.

Figure 2: Key dates in California v. Subsequently, the 5 th Circuit allowed four more states to intervene in the case on appeal, bringing the total number of states defending the ACA in the case to The 5 th Circuit also allowed the U. House of Representatives to intervene in the case to defend the ACA on appeal. Figure 3: Alignment of the Parties in California v. The origins of the case go back to , when the court upheld the constitutionality of the ACA's penalty on individuals who lack health coverage—the so-called individual coverage mandate—as a justifiable exercise of Congress' power to tax.

In December , however, President Donald Trump signed into law a tax bill that eliminated the ACA's penalty on individuals who lack health coverage. Afterward, several Republican state attorneys general, led by the state of Texas, filed a lawsuit arguing that the health care statute itself, or at least the parts of the act closely linked to the individual mandate, were no longer valid.

Democratic states and the House of Representatives, led by Democrats, stepped in to defend the statute. In December , a Texas district court struck down the ACA but stayed its ruling pending appeal, concluding that the individual mandate is so connected to the law that Congress would not have passed the ACA without it.

On appeal, in Texas v. United States , a split panel of the 5th U. Circuit Court of Appeals deemed that the individual mandate was unconstitutional, but the panel instructed the district court to rehear the matter and "to employ a finer-toothed comb on remand and conduct a more searching inquiry into which provisions of the ACA Congress intended to be inseverable from the mandate.

However, on March 2, , before the district court could carry out the appellate court's directive, the Supreme Court announced it would hear the case in its term beginning in the fall of , blocking the lower courts from taking further action. The case the Supreme Court will decide is now titled Texas v. When the 5th Circuit instructed the district court to rehear the matter and to focus on those ACA provisions that Congress intended to be "inseverable from the individual mandate," this suggested, legal analysts said, that the appellate court was unlikely to overturn the ACA in full.

As a result, "plan sponsors know that the entire Affordable Care Act will not be overturned. Had the case proceeded at the appellate level, the 5th Circuit might have struck down those parts of the law directly related to the individual mandate. The appellate decision noted, for instance, that community rating, which prevents insurers from varying premiums within a geographic area based on age, gender, health status or other factors, might be among the provisions determined to be "inseverable" from the individual mandate, because the increase in revenue to insurers from the mandate was meant to offset the decrease from these restrictions.

The ACA's guaranteed-issue provisions, which ban insurers from rejecting coverage based on a person's pre-existing conditions, might also be inseverable, the appellate decision noted. The Supreme Court has the following options when it decides the case , The Washington Post and other sources have reported:. According to an analysis by the nonprofit Kaiser Family Foundation , "If the Supreme Court adopts the position that the federal government took during the trial court proceedings and invalidates the individual mandate as well as the protections for people with pre-existing conditions, then federal funding for premium subsidies and the Medicaid expansion would stand, and it would be up to states whether to reinstate the insurance protections.

If that were to happen, Congress also could reinstate protections for people with pre-existing conditions. Joe Biden, the Democratic presidential nominee, has voiced his support for the ACA, sometimes referred to as Obamacare, pointing out how it safeguards people who might not otherwise qualify for coverage. His campaign website says, "Because of Obamacare, over million people no longer have to worry that an insurance company will deny coverage or charge higher premiums just because they have a pre-existing condition —whether cancer or diabetes or heart disease or a mental health challenge.

President Trump has also pledged to maintain these protections even as his administration supports the lawsuit that seeks to overturn the act. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may have an effect on your browsing experience. Necessary Necessary. Analytics analytics. Performance performance. Allyson N. Mark A.

Lucas C. The court sent the rest of the law back to a lower court to determine if it could still stand. The states urged the justices to take the case and resolve it this term, ahead of the presidential election. The top court did not indicate when it will hear the case, but it will likely do so in its term beginning in October. A decision would be expected by the end of June , after the next presidential term has begun. The case is the latest challenge to the law, more commonly known as Obamacare, which has twice before withstood challenges at the Supreme Court.