Court Challenge Only Strengthened ACA, Analyst Says

By Susan Rupe

The Affordable Care Act has been upheld by the U.S. Supreme Court on three different occasions, and each time the court rules in favor of the law, the law is strengthened and more stability is created around the ACA marketplace.

That was the word from Joel Ario, managing director of Manatt Health and former Pennsylvania Insurance Commissioner.

Ario told InsuranceNewsNet that Thursday’s Supreme Court decision that left the Affordable Care Act intact against its latest legal challenge means that the law has become even more engrained into the American social safety net.

Earlier on Thursday, the high court upheld the Affordable Care Act in a 7-2 ruling, knocking down the law’s latest Republican challenge.

A group of 18 Republican states, led by Texas, focused on the law’s tax penalty meant to induce the purchase of health insurance by most Americans. They argued that President Trump’s 2017 tax cut, which zeroed out the penalty, made that provision unconstitutional.

The court did not address that issue. Justice Stephen Breyer said the states lacked the standing to challenge the law’s individual mandate.

Two of the court’s staunchest conservatives, Justices Samuel Alito and Neil Gorsuch, were the dissenting votes. Alito criticized the majority for preventing the plaintiffs from “even get[ting] a foot in the door to raise a constitutional challenge.”

Ario said that during oral arguments in the case, heard in November 2020, the justices indicated that the ACA could stand even without the individual mandate penalty.

President Joe Biden has stated his support for strengthening the ACA, and Ario said he believes the court decision will move the needle toward that goal.

“You’re seeing that already with increased subsidies and the federal government putting more money into enrollment,” he said. ”So I think the result is more insurer participation and more consumer control.

The Law Of The Land – For Now

The court’s ruling means he health care law “remains the law of the land for the foreseeable future,” said Marcy Buckner, senior vice president of government affairs for the National Association of Health Underwriters.

Bucker told InsuranceNewsNet that her association is telling its members the ACA remains the law for now, although ”it doesn't mean that this is forever and always.”

“Obviously, there could be future cases that could disrupt that, or there could be changes from Congress or the administration. But for the foreseeable future, this will remain the law of the land.”

Bucker said her association members questioned whether today’s ruling means the ACA will remain in place forever.

“I think it's worth mentioning here that no, it doesn't mean that this is forever and always. And this was the third time the Supreme Court heard a case regarding the ACA. But this does not mean that the ACA is forever and always in place. It just means for now, it is.”

Buckner said that moving forward, NAHU is focusing its efforts on keeping up with anticipated regulatory changes to health care law.

“We know that Congress and the Biden administration may have different policy directions that they’re going to take now that the court has ruled,” she said. “We also know there is a large pile of regulatory work that we’re awaiting – from surprise billing to broker disclosures. So on one hand, [the court decision] kind of frees up the agencies to work on those things. But on the other, it could cause them to have some things to work on possibly later on, especially with President Biden's directive at the beginning of the year for the agencies to review some of former President Trump's actions on short-term limited duration plans, association health plans, all of those things that if you follow down far enough, came from the ACA.”

Matt Eyles, president and CEO of America’s Health Insurance Plans, said his organization believes “the Supreme Court rightly concluded this case does not belong in court, as the challengers have not suffered any injury.”

With millions of Americans receiving health coverage through the ACA and an additional 1 million signing up for coverage in a special enrollment period earlier this year, Eyles said “it is clear that Americans agree we should continue to build on the ACA to improve coverage and care for everyone.”

Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected]. Follow her on Twitter @INNsusan.