Supreme Court justices hear arguments in Affordable Care Act case

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U.S. Supreme Court Justices on Tuesday heard arguments in California v. Texas, a case that seeks to overturn the Affordable Care Act.

The lawsuit, filed by a Texas-led coalition and later supported by the Trump Administration, argued that a Republican-led Congress rendered the ACA’s individual mandate unconstitutional when it reduced the penalty for forgoing coverage to $0. They further argued that the rest of the ACA, signed into law by President Barack Obama in 2010, should be held invalid as a result of that change.

The California attorney general’s office and 20 other states filed a countersuit. The two cases were merged ahead of oral arguments.

Protesters in front of the U.S. Supreme Court building in Washington Tuesday as justices listened to oral arguments in a case challenging the Affordable Care Act.

“What’s before the court is an enormously important statute that provides insurance to millions of Americans,” said Michael Morgan, the California solicitor general.

Roughly 20 million Americans get health insurance through ACA. The law allows parents to keep their children on their health insurance until the age of 26 and prevents insurance companies from dropping people because of preexisting conditions.

In his rebuttal argument, Morgan pointed to statements made by Congress and President Trump when the mandate that penalized Americans who didn’t buy insurance was eliminated through an amendment.

“If you look at exactly how Congress and the President understood the amendment,” Morgan said. “It allows Americans the freedom to decide if they want to buy insurance.

Eight years ago, a high court ruling left the essential components of ACA intact, but the high court is now controlled by a 6-3 conservative majority after Trump’s appointment of Justice Amy Coney Barrett.

Some justices appeared skeptical of arguments from the Texas attorney general’s office and the U.S. Solicitor General that the entire law should be voided.

Texas Solicitor General Kyle Hawkins argued that though the penalty had been removed by Congress, the language of the law still suggests that Americans should have insurance, making it a mandate.

But Chief Justice John Roberts and Justice Brett Kavanaugh made statements that suggest that they may view the individual mandate as severable from the rest of the law. If those two justices join the court's three liberals in finding that the court mandate is severable, that would provide a five-vote majority to save ACA.

“I tend to agree with you that this a very straightforward case for severability under our precedents, meaning that we would excise the mandate and leave the rest of the Act in place,” Kavanaugh told Donald Verilli, the attorney for the U.S. House of Representatives defending the law.

If the court overturned the law, it would cost California billions in Medi-Cal reimbursements from the federal government.

California went all-in on ACA, being one of the first states to create a statewide medical exchange providing insurance to the uninsured on a sliding scale. The move greatly expanded the number of people in California that qualified for Medi-Cal, the state’s Medicaid program, which provides medical benefits to impoverished people.

Under ACA, states were expected to receive additional money for state Medicaid programs to expand the number of citizens who are insured, which would then be reimbursed by the federal government.

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