The Supreme Court is unlikely to consider the fate of the Affordable Care Act before the 2020 presidential election after denying a request Tuesday from supporters of the law to fast-track consideration of the case.
The ruling sets aside the potential for another major shift in the political landscape prior to the election on an issue that has dominated American politics for the last decade.
President Donald Trump’s effort to repeal Obamacare was central to Democrats sweeping into power in the House in the 2018 midterms — a victory that came eight years after Republicans had gained the House majority on their opposition to Obama’s signature health care law.
But in the decade since the Affordable Care Act became law, elements of it — such as requirements that insurers cover those with pre-existing conditions — have become popular, turning health care politics in Democrats’ favor.
It’s already sure to be a focal point of the 2020 election. The law’s future is at the center of the Democratic presidential primary, with more moderate candidates like former Vice President Joe Biden and former South Bend, Indiana, Mayor Pete Buttigieg saying they want to expand on Obamacare by allowing Americans to buy into a Medicare-style public insurance option. More progressive candidates like Vermont Sen. Bernie Sanders and Massachusetts Sen. Elizabeth Warren say they favor scrapping private insurance altogether for a government-run single-payer “Medicare for All” system.
The justices were asked to quickly rule on the appeal of a ruling from the 5th US Circuit Court of Appeals that held Obamacare’s individual mandate was unconstitutional, but had sent the case down to a Texas federal court to decide the fate of other provisions of the sprawling law.
Lawyers for the Democratic-led House of Representatives, as well as California and other Democratic-led states, seeking to keep the law intact, told the justices they needed to step in immediately given potential for the “profound destabilization of the health care system,” as California’s brief put it.
Following that move, the Trump administration said in a filing that it didn’t want the justices to act quickly on the case since the key issue — how much of the law should remain in effect — is still being litigated. The administration is siding with Texas and several GOP-led states in arguing the law should be struck down.
“By refusing to expedite the ACA case, the justices are basically saying that they’d rather not decide this case until they absolutely have to — which, depending on how the November elections go, may be never,” said Steve Vladeck, CNN Supreme Court analyst and professor at the University of Texas School of Law.
“They may still choose to hear the current appeal, or wait for the case to go back to the district court before taking it up, but either way, the earliest we’d get a decision from the court about the fate of Obamacare would be the middle of 2021. Thus, in a term that is already full of high-profile cases with major potential political ramifications, the court decided to sit this one out, at least for now.”
In 2012, Chief Justice John Roberts cast the key vote in the landmark 5-4 decision on the act, holding that the individual mandate was valid under Congress’ taxing power. But in 2017, the Republican-led Congress cut the tax penalty for those who lacked insurance to zero as part of the year-end tax overhaul.
Texas and other Republican-led states sued arguing that since the mandate was no longer tied to a specific tax penalty, it had lost its legal underpinning. They also argued that because the individual mandate was intertwined with a multitude of other provisions, the entire law should fall, including protections for people with pre-existing conditions.
In the circuit court’s decision last month, the court punted on whether the rest of the massive law — even provisions unrelated to the mandate — could remain on the books. Over 98 pages, the 2-1 appeals court asked a district court to review that issue, infuriating supporters of the law.
In an effort to get the justices to review the lower court’s decision, Donald Verrilli, a lawyer for the Democratic-led House, said in a filing earlier this month that the law is a “fixture of the American health-care system” and urged the justices in legal briefs to review the “remarkable” lower court decision that “threatens profound destabilization of the health care system.”
“The present case represents yet another effort by litigants who disagree with the policy judgments embodied in the ACA to use the courts, rather than the democratic process, to undo the work of the people’s elected representatives,” the filing stated.
They noted that the law has become embedded in American society with popular provisions, including one that says that the more than 100 million individuals with pre-existing conditions including cancer, diabetes, asthma and high blood pressure, could not be denied coverage.
This story has been updated with additional details of the case.