Rejecting a challenge by Florida and 17 other states, the U.S. Supreme Court upheld the Affordable Care Act (ACA) for the third time on Thursday, leaving in place the broad provisions of the law enacted by Congress in 2010. The vote was seven-to-two.
The majority decision threw out the challenge to the law without even considering the merits of the arguments on the grounds that Florida and other objecting GOP-dominated states were not required to pay anything under the mandate provision and thus had no standing to bring the challenge to court.
“To have standing, a plaintiff must ‘allege personal injury fairly traceable to the defendant’s allegedly unlawful conduct and likely to be redressed by the requested relief,’ ” but “No plaintiff has shown such an injury,” the court said.
The opinion, written by Justice Stephen Breyer, was joined by Chief Justice John Roberts and Justices Amy Coney Barrett, Elena Kagan, Brett Kavanaugh, Clarence Thomas, and Sonia Sotomayor.
Justices Samuel Alito and Neil Gorsuch dissented.
“As always, we respect the authority and ruling of the court,” said Florida Attorney General Ashley Moody in a statement.
But she also said, ““My office will always push back on any federal overreach limiting the authority of the States. We have consistently supported coverage for people with preexisting conditions and we believe this was an important matter for the nation’s highest court to weigh in on.”
Florida Democrats and ACA supporters took a victory lap.
“For the third time, SCOTUS has upheld the #ACA as the law of the land!” U.S. Representative Debbie Wasserman Schultz tweeted. “Millions of Americans rely on the law and its protections for pre-existing conditions, and I will never stop fighting to defend it from GOP attacks.”
Florida Policy Institute CEO Sadaf Knight said, “The opinion issued today by the U.S. Supreme Court will preserve coverage for 23 million Americans by ending the lawsuit brought by Florida’s Attorney General Ashley Moody and 17 other attorneys general to gut the Affordable Care Act, or ACA.
“It’s time to end attacks on the ACA. With the lawsuit in the rearview mirror, it’s time for Congress to focus on strengthening the ACA by closing the health care coverage gap for 2.2 million uninsured adults across the country and enacting permanent ACA marketplace reforms to make insurance coverage more affordable.”
The law, approved in 2010 by congressional Democrats and then-President Barack Obama, requires insurance companies to sell policies to all individuals regardless of health status. Previously, insurance companies did not face such a “guaranteed issue” requirement to sell policies to everyone, and there was not a “high risk” pool for people with potentially expensive conditions to purchase coverage.
The mandate required that people either buy health insurance or pay a penalty. It was challenged in the U.S. Supreme Court. In 2012, it was upheld by a five-to-four vote, with Roberts casting the decisive fifth vote, on the grounds that the penalty fell within the taxing power of Congress.
In 2017, however, Congress got rid of the penalty after the Congressional Budget Office concluded that the law would continue to function effectively without it.
That prompted the challengers to go back to court.
The states filed a lawsuit in which they argued that without the penalty the individual mandate is now unconstitutional. They further argue that the mandate is so essential to the ACA that it cannot be severed from the rest of the law, meaning the entire ACA should be struck down. At a minimum, they asked the court to strike down the law’s guaranteed issue and community rating provisions alongside the mandate.
Florida Democrats warned that hundreds of thousands of Floridians with pre-existing conditions would lose coverage if ACA was eliminated. As a result, the Republican-controlled Legislature in 2019 passed a bill that would require insurance companies and health maintenance organizations to offer at least one policy that would not exclude, limit, deny or delay coverage because of pre-existing conditions.
But critics argued the requirement, which would take effect only if the federal law was repealed or found unconstitutional, would not ensure that the policies would be affordable.