In the News
Houston Chronicle: Supreme Court upholds Affordable Care Act, tossing Texas challenge
Washington, June 17, 2021
Tags: Health Care
Democrats were energized by the decision, which landed as a group of Texas Democrats in Congress rolled out legislation aimed at expanding Medicaid in states such as Texas. The bill would let local leaders bypass states to accept federal resources directly, essentially letting cities and counties opt to expand Medicaid.... Reps. Lizzie Fletcher and Sylvia Garcia of Houston, Veronica Escobar of El Paso and Henry Cuellar of Laredo are also supporting the bill.
The Supreme Court on Thursday tossed out Texas’ challenge to the Affordable Care Act, ruling that the GOP states seeking to tank the health care law lacked standing to sue over a $0 penalty adopted by Congress.
The 7-2 ruling marked the third time the health care law has survived Republican challenges and comes as more Texans are using the coverage more than ever. The state, which has the highest uninsured rate in the nation, saw an uptick in enrollment in government health care during the pandemic. Over 1.5 million Texans now rely on Obamacare.
Democrats were emboldened by the ruling, calling it a sign of the law’s resilience.
But the court was clear that it did not rule on the constitutionality of the law but rather on the strength of Texas’ arguments.
Thursday’s ruling marks the second time in six months the court has smacked down a lawsuit brought by Texas Attorney General Ken Paxton as the Republican has sought to put himself on the front lines fighting against the Biden administration. The court refused to consider Paxton’s attempt to overturn the presidential election results in December. In the case of the Affordable Care Act, the court deemed his arguments illogical and counterintuitive.
BACKGROUND: Texas’ case to abolish the Affordable Care Act
Republicans argued that the ruling “settles nothing” and said the door is open for future challenges.
Texas and 17 other states had argued that the health insurance mandate included in the law — with penalties for noncompliance that Congress reduced to $0 in the GOP’s 2017 tax code overhaul — led more residents to sign up and increased costs to run state-operated medical insurance programs. The court said they failed to prove that case.
“Neither logic nor evidence suggests that an unenforceable mandate will cause state residents to enroll in valuable benefits programs that they would otherwise forgo,” Justice Stephen Breyer wrote in the court’s opinion. “It would require far stronger evidence than the states have offered here to support their counterintuitive theory of standing.”
The court similarly ruled that the individual plaintiffs — including Neall Hurley, a Fort Bend man who says he now pays nearly $25,000 out of pocket every year to cover the costs for monthly premiums and expenses for his family of four — also lack standing.
Hurley, who is self-employed and runs a parking technology company, argued that he felt compelled to obey the health care law’s individual mandate, even after Congress reduced it to $0.
“Unenforceable statutory language alone is not sufficient to establish standing,” Breyer wrote.
The justice also wrote that if the court had granted standing, it would give federal judges undue power: “It would threaten to grant unelected judges a general authority to conduct oversight of decisions of the elected branches of government.”
An attorney for the individual plaintiffs said he was “perplexed” by the ruling.
“Today’s takeaway by the court is that apparently it’s a license to ignore the commands of federal law if there’s not a direct punishment tied to it,” said Rob Henneke, general counsel at the conservative Texas Public Policy Foundation.
Two conservative justices, Samuel Alito and Neil Gorsuch, dissented in the case, calling the ruling an “improbable rescue” from a “serious threat.”
“No one can fail to be impressed by the lengths to which this court has been willing to go to defend the ACA against all threats,” Alito wrote. “A penalty is a tax.”
Justice Clarence Thomas, another conservative on the court, disagreed with their assessment, writing in a concurring opinion that the ruling wasn’t the court “rescuing the ACA” but rather “adjudicating the particular claims the plaintiffs chose to bring.”
Increase in coverage
The decision comes as Paxton, who led the 18 states in the case, faces a reelection campaign that could pose his most serious political challenge yet.
Political experts didn’t expect the court’s assessment of Paxton’s legal arguments in the case to carry much weight with Republican primary voters in Texas.
The lawsuit was as much about signaling to conservative voters as it was winning, they say, as is the case with a slew of lawsuits he’s filed against the Biden administration over the last six months, challenging the president’s moves on oil, immigration and more.
“Ultimately, Ken Paxton, like most AGs, picks and chooses the cases he wants to pursue and emphasize to voters — and he has been very good about choosing cases and issues that put him in a good light with Republican primary voters,” said Joshua Blank, research director at the University of Texas at Austin’s Texas Politics Project.
Similar to what he did when the court tossed his election challenge, Paxton criticized the ACA ruling because it centered on the state’s legal standing to bring the case, rather than on constitutional issues he raised. The judges “avoided” that question, he said.
The ruling comes after Texas saw the biggest increase in ACA sign-ups of any state during the coronavirus pandemic, with over 15 percent more Texans signing up during the 2021 open enrollment period than the year before.
The ACA has steadily gained steam in Texas. Nearly 1.3 million Texans signed up for 2021 coverage by the end of 2020 — up from 1.1 million the year before. An additional 239,000 have signed up during the COVID-related special enrollment period that began Feb. 15.
Democrats were energized by the decision, which landed as a group of Texas Democrats in Congress rolled out legislation aimed at expanding Medicaid in states such as Texas. The bill would let local leaders bypass states to accept federal resources directly, essentially letting cities and counties opt to expand Medicaid.
Rep. Lloyd Doggett, an Austin Democrat whose district includes part of San Antonio and who chairs the House Ways and Means Health Subcommittee, said the ruling was “wonderful for the hundreds of millions who benefit from access to health care.”
“No better way to celebrate this victory than by working to further fulfill that promise, as we’ve done today,” he said.
Reps. Lizzie Fletcher and Sylvia Garcia of Houston, Veronica Escobar of El Paso and Henry Cuellar of Laredo are also supporting the bill.
Conservatives, meanwhile, said more challenges are likely.
“Americans are still stuck with an expensive health care system that is forcing people into bankruptcies because of exploding health care costs,” Henneke said. “That’s little to celebrate about.”
“There’s going to continue to be challenges to the various aspects that this law intrudes into the rights and autonomy of Americans,” he said.