California v. Texas
Issue: Do Texas and individual plaintiffs have standing to challenge the Affordable Care Act (ACA)? If so, did the Tax Cuts and Jobs Act, which set the penalty for violating the mandate at $0.00, render the individual mandate unconstitutional? If the individual mandate is unconstitutional, is it severable from the remainder of the ACA?
Background: In 2012, the U.S. Supreme Court upheld the constitutionality of the ACA’s individual mandate under Congress’s power to tax. In 2017, Congress set the penalty for violating the individual mandate at zero dollars. Texas, along with several other states, and two individuals filed a lawsuit arguing that the individual mandate was no longer a valid exercise of Congress’s power to tax and that the entire ACA should be struck down. Because the Trump Administration sided with the plaintiffs, California and several other states intervened to defend the ACA.
The district court held that the individual mandate was unconstitutional and as a result, the entire ACA is invalidated because the individual mandate could not be “severed” from the rest of the ACA. On appeal, the 5th Circuit agreed that the individual mandate was unconstitutional and sent the case back to the trial court for additional analysis about whether any part of the ACA should survive without the individual mandate. The U.S. Supreme Court then agreed to hear the case, and in a 7:2 opinion, found that the plaintiffs lacked standing to challenge the individual mandate.
Current Status: Final decision issued
U.S. Supreme Court Amicus Brief, May 13, 2020
Amici: American Public Health Association, American Academy of Nursing, and 210 public health deans and scholars.
Argument Summary: The ACA has advanced public health in immeasurable ways by transforming the individual health insurance market and implementing vital public health reforms. Due to the ACA, more than 90% of Americans have some form of health insurance and are more likely to receive care when they need it along with seeking out preventative care. As such, striking down the ACA would cause lasting damage to public health moving forward, given the ACA’s irreversibly entwined nature with the American healthcare system. Whether to keep a statute like the ACA, with far-reaching consequences for public health policy, should be an issue for the political branches to determine. Congress has repeatedly affirmed the ACA’s core policies by building on them when addressing public health challenges and declined on numerous instances to repeal the ACA in its entirety.
Outside Counsel: McDermott Will & Emery
Related Resources:
GW Milken School of Public Health. Repeal of Affordable Care Act Would Devastate Health Care for Millions of Americans and Worsen COVID Pandemic, Says Public Health Amicus Brief. May 12, 2020. https://publichealth.gwu.edu/repeal-affordable-care-act-would-devastate-health-care-millions-americans-and-worsen-covid-pandemic
American Public Health Association Media Relations. Repeal of Affordable Care Act Would Devastate Health Care for Millions of Americans and Worsen COVID-19 Pandemic, Says Public Health Amicus Brief. May 12, 2020. https://www.apha.org/news-and-media/news-releases/apha-news-releases/2020/aca-repeal-would-devastate
Citations:
Keith K. Wide Range of Amici Support California, House in Texas Litigation. Health Affairs Blog. May 16, 2020. https://www.healthaffairs.org/content/forefront/wide-range-amici-support-california-house-texas-litigation
Jost T. Amicus Briefs Flood In, Supporting the ACA. To the Point (blog), Commonwealth Fund, May 20, 2020. https://doi.org/10.26099/65t3-rb80