On Monday, the Supreme Court of the United States (SCOTUS) announced that it would take up Texas v. United States and review the constitutionality of the Patient Protection and Affordable Care Act (ACA), more commonly referred to as Obamacare.  Citizens Against Government Waste wrote about the challenge to Obamacare in a December 2019  WasteWatcher.  The challengers to ACA are arguing that the individual mandate is unconstitutional with the tax penalty now at zero dollars.

What is important to remember is no one will see any changes with their health insurance as this case goes through the litigation process.  But what this lawsuit should do is remind us how bad Obamacare has been.  It has raised healthcare costs, created much narrower insurance networks, and provided fewer choices for Americans.

Based on the SCOTUS schedule, it is likely the case will be heard in the fall, just before the 2020 presidential election.  No decision will be made until 2021, probably in the spring or summer.

It is obvious healthcare reform will be the major topic in the presidential election.  We will hear a lot about how Republicans have no solutions for those with pre-existing conditions.  This is not true.  As written in CAGW’s December blog, there are two plans that Republicans have been working on for more than a year.  One plan is offered by the House Republican Study Committee, “A Framework for Personalized, Affordable Care.”  The other, “The Healthcare Choices Proposal” has the attention of conservative Senators.

The plans have different approaches on how to implement their ideas but agree on the major issues that Americans care about such as protecting people with pre-existing conditions, improving choices, and lowering costs.  Both plans want to empower Americans to have the kind of healthcare plan they want; not what Washington D.C. politicians and bureaucrats prescribe.

President Trump is also doing what he can to improve our healthcare choices by making changes to Obamacare through state innovation waivers.  Most of the states using these waivers have implemented risk pools or reinsurance that have helped to lower premium costs and protect individuals with pre-existing conditions.  CAGW wrote about the success of these waivers in a September 2019 blog.

Texas v. United States will be a top discussion for the 2020 presidential campaign so here is a brief summary.  The Supreme Court first held up the constitutionality of Obamacare on June 28, 2012 by saying the individual mandate to purchase insurance was actually a tax.  Keep in mind, most of Obamacare had not yet become effective at that time.  President Obama took a victory lap after the SCOTUS decision, telling us we would not lose our insurance or our doctor.  Less than two years later, in January 2014 when the law became effective, Americans found out otherwise.

Chief Justice John Roberts, who wrote the majority opinion, said, "The Affordable Care Act is constitutional in part and unconstitutional in part.  The individual mandate cannot be upheld as an exercise of Congress’s power under the Commerce Clause.  That Clause authorizes Congress to regulate interstate commerce, not to order individuals to engage in it.  In this case, however, it is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but choose to go without health insurance.  Such legislation is within Congress’s power to tax.”

Jump ahead to Texas v. United States when the Texas state attorney general and other Republican state attorneys general and governors from 20 states challenged the constitutionality of Obamacare because the tax penalty for not purchasing health insurance had been reduced to $0.0 due to the Tax Cuts and Jobs Act of 2017.  The Trump administration chose not to defend Obamacare in the case so Democratic attorneys general from 16 states and the District of Columbia stepped in to fight for Obamacare.

In December 2018, a federal district court judge in Texas agreed with the Republican AGs argument about the individual mandate.  From there, the ruling was appealed to the Fifth Circuit Court in Louisiana.  The circuit court upheld the district court’s decision and the case was appealed to the Supreme Court, where it sits for a final decision.  Now that the tax penalty is zero, Chief Justice Robert's opinion in the original case is in question.