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The Supreme Court Is Hearing a Case That Could Overturn the Affordable Care Act

ACA chart in court

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Key Takeaways

  • The Supreme Court is hearing oral arguments in a case to overturn the Affordable Care Act (ACA) today, but no decision is expected before the spring. 
  • The ACA contains many provisions which Americans depend on, including coverage for pre-existing medical conditions and keeping adult children on their parent’s health plans until age 26. 
  • Despite the case before the Supreme Court, this is the enrollment period for federal and state health insurance plans, and for many employer-based plans as well. 

It’s another big news week. Today, the Supreme Court will hear oral arguments from attorneys bringing a lawsuit against the Affordable Care Act (ACA), also, known as Obamacare. The case is called California v. Texas and is spearheaded by 18 Republican attorneys general, two Republican governors, and two individual citizens. 

The lawsuit centers around the fact that the ACA, originally passed in 2010, requires that every individual in the U.S. have health insurance or pay a penalty. But in 2017 during tax reform legislation Congress reduced the penalty to zero. And so, the case before the Supreme Court argues that without an actual amount for the penalty, the law is unconstitutional. 

“The most important thing for people to know right now is that the ACA is the law of the land and nothing has changed to your health insurance,” Frederick Isasi, executive director of Families USA, a national, nonpartisan consumer health care advocacy organization, based in Washington, DC, tells Verywell.

There have been many challenges to the ACA over the years, and news coverage of the cases can be confusing for many Americans who sometimes think court hearings have ended their health insurance. Isasi and other health policy experts stress clarity regarding health insurance coverage is especially important during the COVID-19 pandemic, since people may need testing and treatment.

The Court will hear oral arguments by phone today because of the pandemic instead of at the august Supreme Court building. But experts have said they don’t expect a decision until the close of the Court’s current term, which ends in June.

What This Means For You

The Supreme Court is hearing the case today, but isn’t expected to rule before the spring. That means that despite the pending case, there have been no changes to your health insurance.

What's at Stake?

Before the ACA, buying health insurance was often too expensive for people who didn’t receive coverage through a job, and even for many who did. Through lower costs, subsidies, and an expansion of Medicaid eligibility in many states, the ACA has provided health coverage to more than 23 million people, according to the Center for American Progress (CAP), a think tank in Washington, D.C. This includes three million who began ACA coverage since the pandemic began.

"Overturning the ACA would send the healthcare system into total chaos,” Cynthia Cox, vice president at the Henry J. Kaiser Family Foundation and director for the Program on the ACA, tells Verywell.

Among the most significant provisions of the ACA is the requirement that people not be excluded from buying health insurance because of pre-existing health conditions. Before the ACA was passed health, insurers could deny coverage to someone with a pre-existing health condition ranging from spring allergies to cancer, charge them more for coverage, or exclude the health condition from coverage altogether. Under the ACA, both employer-based and marketplace health insurance may not exclude anyone, charge more, or deny coverage for a pre-existing health condition.

That tenet of the law may be especially important now. Some people with COVID-19 have lingering symptoms ranging from fatigue and confusion to organ damage, and as a result, COVID-19 may eventually be considered a pre-existing condition.

President-elect Joe Biden, who served as Vice President to President Obama while the Affordable Care Act was developed and passed, is expected to make remarks about the Supreme Court case today. But the President-elect “can’t make the lawsuit go away,” Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation, tells Verywell.

If the law is overturned, passing a new law guaranteeing at least the same protections of the ACA would depend on the composition of Congress. Few Republicans have ever voted in favor of the ACA, and many have voted to repeal it over the last 10 years. January runoff elections in Georgia for the state’s two Senate seats could determine whether there might be enough U.S. Senate votes to pass a new healthcare law if the ACA is indeed overturned.

For now, though, it’s critical to remember that the ACA is still the law and all your health insurance is intact. What’s more, for people who get their health insurance coverage through federal and state marketplaces, signup for 2021 is going on right now. It lasts through December 15 for the federal insurance exchanges, and even longer in some states. 

"Don't not sign up for 2021 coverage because you fear what the Supreme Court may do,” Levitt says. 

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  1. Schneider EC, Shah A. Will the pandemic increase the number of Americans with preexisting conditions? The Commonwealth Fund. Updated October 8, 2020.