PD Editorial: Obamacare is settled law after failed challenges

For the third time in less than 10 years, the U.S. Supreme Court rejected a challenge to the Affordable Care Act, thereby preserving medical coverage for more than 30 million Americans.

In baseball, it’s three strikes and you’re out.

The same rules don’t apply to litigation, but even the most committed Obamacare antagonists can’t overlook the lopsided 7-2 majority, including four of the six conservative justices.

Thursday’s outcome is welcome news for millions of people who gained access to health insurance through the 2010 law. It also should offer some hope to those who fear the polarization that characterizes American politics will infect the Supreme Court, turning it into another partisan battleground.

As a practical matter, after 15 months spent battling a highly contagious and potentially fatal virus, can anyone still doubt the necessity of ensuring access to decent medical care? Isn’t it time to accept the Affordable Care Act as settled law?

This latest legal challenge came from a coalition led by Republican state attorneys general and, like the first trip to the Supreme Court, turned on the “personal responsibility” provision, a mandate that people carry health insurance, just as motorists are required to carry auto insurance.

In a 2012 case questioning the constitutionality of the mandate, the high court upheld the law, including the tax penalty for failing to carry health insurance. Three years later, the court rejected a challenge to subsidies for low- and middle-

income Americans who buy insurance.

In 2017, when Republicans assumed control of both houses of Congress and the White House, they tried (yet again) to repeal the law. When that failed, Congress passed and Donald Trump signed a bill eliminating the tax penalty.

The attorneys general followed up with their lawsuit, arguing that the constitutional framework of the Affordable Care Act rested on the tax penalty. Without it, they contended that the entire law, including the popular provision barring discrimination based on preexisting medical conditions, should be overturned. The Trump administration concurred, and two lower courts went along.

But it was a flimsy argument, and the court wasn’t buying.

“The IRS can no longer seek a penalty from those who fail to comply,” Justice Stephen Breyer wrote for the majority. Therefore, “there is no possible Government action that is causally connected to the plaintiffs’ injury.” In other words, no one is injured by a law that has no penalty, so there is no basis for a lawsuit.

Meanwhile, millions of people are benefiting from insurance.

While it was widely assumed that repealing the penalty would start a death spiral for Obamacare as people canceled their policies, the latest Health and Human Services figures show a record 31 million people have obtained private insurance or Medicaid coverage through the Affordable Care Act. A million signed up during a special pandemic-related enrollment period earlier this year.

Moreover, the Urban Institute reported in May that average premiums have gone down in each of the three years since the tax penalty was eliminated.

Is there work to be done? Of course. Any large government program can be improved. Obamacare is no exception. Californians can choose from multiple plans from about a dozen insurers, but some states have a single provider. States want more flexibility with reinsurance programs. Health care spending is still spiraling out of control.

The question is, after striking out again, will critics drop the legal challenges and focus on making Obamacare better?

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