Getty Images

Supreme Court Will Not Expedite ACA Constitutionality Review

The Supreme Court will not expedite the review and supporters of the court’s decision say that ACA constitutionality is not the issue at hand.

The Supreme Court will not expedite a review of the Affordable Care Act’s (ACA’s) constitutionality.

The Fifth Circuit Court of Appeals declared the individual mandate void in December 2019, but made no decision regarding the constitutionality of the law as a whole. Instead, the Fifth Circuit sent the case back to the lower district court to parse out the legal implications of this decision.

In response, Democrats and organizations from across the healthcare industry requested that the Supreme Court take up the issue to decide the embattled ACA’s fate. 

“For nearly a decade, the Affordable Care Act has been the backbone of our nation’s healthcare, paving the way toward better care with protections that keep our loved ones healthy and covered,” California Attorney General Xavier Becerra stated before the Supreme Court made its decision regarding this request. 

“Our healthcare should never be used as a political football — people’s health isn’t a game, it’s a matter of life and death. Today, a bipartisan coalition of legal experts, patient and physician advocates, economists, and public health experts agree: This repeal lawsuit will cause immense harm and uncertainty, so our fight to save affordable healthcare must go all the way to the Supreme Court.”

If the Supreme Court were to deliberate and rule on the ACA’s constitutionality, the decision would be determined before the end of the term in June 2020. Those in support of expediting the process said that to allow the process to languish in lower courts would cause dangerous uncertainty for Americans who are covered by ACA plans. 

Specifically, the supporters noted beneficiaries with pre-existing conditions, low- and middle-income families, those who would be affected by a lifetime insurance limit, and young people under the age of 26 who are still on their parents’ health plan.

“As we indicate in our brief, returning this case to the district court on remand only delays what Congress has unmistakably indicated through its actions: that the ACA should continue in operation despite its zeroing out of the mandate,” Matt Eyles, president and chief executive officer of America’s Health Insurance Plans (AHIP), said in a statement before the decision was announced. 

“The district court’s original decision to invalidate the entire ACA was misguided and wrong. We urge the Supreme Court to grant certiorari and remove the overhanging legal uncertainty that undermines the stability of coverage for nearly 300 million Americans, and that inhibits greater and faster progress to improve coverage and care for everyone.”

In its amicus brief, AHIP noted that to rule the ACA as unconstitutional would disrupt the healthcare industry because of the ACA’s scale and scope and its connections to the individual health insurance market, group health insurance market, Medicaid, and Medicare.

Instead, however, the Court decided not to expedite the plan.

“The Fifth Circuit’s decision itself does not warrant immediate review because it did not definitively resolve any question of practical consequence,” argued the solicitor general Noel Francisco. “To be sure, lower-court decisions holding federal statutes invalid often do warrant this Court’s review. But here the Fifth Circuit held that the mandate is unconstitutional precisely because it is no longer backed by the only original consequence (a monetary obligation) for noncompliance.”

Essentially, the solicitor general said that the constitutionality of the ACA was not yet the issue at hand and, therefore, those pushing an expedited process could not rush to defend the ACA when it was not yet officially under attack.

As a result, the case will continue as planned to lower courts. The case could remain there for years.

Dig Deeper on Healthcare policy and regulation