Supreme Court upholds ACA, turns focus back to Medicaid expansion

US Supreme Court

The question revolved around the ACA's individual mandate, which initially required most Americans to carry health insurance or pay a fine.

West Virginia Attorney General Patrick Morrisey said his state was "deeply disappointed that the court ducked the question about the unconstitutionality of the individual mandate". In their decision, the justices determined that states lacked the standing to bring their case to federal court.

"While the Supreme Court ruled today that states do not have standing to challenge the mandate, the ruling doesn't change the fact that Obamacare failed to meet its promises and is hurting hard-working American families", the statement said.

The big picture: The makeup of the court became much more conservative during the Trump presidency, thanks in part to Senate Majority Leader Mitch McConnell refusing to give Obama nominee Merrick Garland a vote in 2016.

"Unsurprisingly, the states have not demonstrated that an unenforceable mandate will cause their residents to enroll in valuable benefits programs that they would otherwise forgo", Breyer wrote.

The Supreme Court in 2012 and 2015 also fended off previous Republican challenges to Obamacare. "But the legislature is where future battles about health care are likely to play out rather than the courts and the Supreme Court, in particular", she said.

That led the red states to argue that the tax was effectively eliminated.

Conservative Justices Samuel Alito and Neil Gorsuch dissented from the ruling. Justices Brett Kavanaugh and Amy Coney Barrett sided with the majority, while Gorsuch was the lone Trump-appointed justice that dissented.

Ohio Attorney General Dave Yost said the lawsuit was "an invitation to judicial activism from the start".

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"We've had to fight tooth and nail to preserve the law from partisan Republican attacks", Schumer said.

President Joe Biden's administration in February urged the Supreme Court to uphold Obamacare, reversing the position taken by the government under Trump, who left office in January. "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".

House Speaker Nancy Pelosi, a Democrat, called the ruling a "landmark victory for Democrats' work to defend protections for people with pre-existing conditions against Republicans' relentless efforts to dismantle them".

President Biden has pledged to expand the Affordable Care Act, which was first enacted during the Obama administration in 2010.

And with a Supreme Court that includes three appointees of former President Donald Trump, opponents of "Obamacare" hoped a majority of the justices would finally kill the law they have been fighting for more than a decade. He and other Democrats had criticized Republican efforts to strike down the law at a time when the USA was grappling with a deadly coronavirus pandemic. Opposition to Obamacare seems to have receded as a political issue for many Republicans as their party has emphasised other matters such as immigration, voting restrictions and hot-button "culture war" issues. The penalty's elimination under the 2017 tax law meant the individual mandate could no longer be interpreted as a tax provision and was therefore unlawful, the Republican challengers argued.

Several Republican-led states on Thursday accused the Supreme Court of ignoring whether Obamacare is unconstitutional or not after the high court handed down a favorable ruling upholding the law.

A federal judge in Texas in 2018 ruled that Obamacare, as structured following the 2017 change, violated the Constitution and was invalid in its entirety.

Those plaintiffs were 18 Republican-run states, later joined by two individuals, who claimed that if you cover one eye and hold the ACA up to the light while turning it counterclockwise, it will appear to be unconstitutional. They claimed in earlier Supreme Court rulings the individual mandate was cited as a tax and with that tax removed the law was unconstitutional.

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