Scotus ACA

April 1, 2021

Will The Law Stand?

The U.S. Supreme Court tackles the Affordable Care Act… again.

The latest legal challenge to the ACA (aka “Obamacare”).


  • 2010: ACA signed into law.
  • 2012: U.S. Supreme Court upheld the ACA’s “individual mandate” (requires most Americans buy insurance or pay penalty) under Congress’ tax powers, declaring the ACA constitutional.
  • 2018: After Congress eliminated the tax penalty under the GOP’s 2017 tax overhaul, a TX federal judge ruled the ACA can’t stand w/o the tax penalty. This ruling is on hold.


  • The Court will decide if the individual mandate is unconstitutional and if Congress’ 2017 elimination of the tax penalty means the entire ACA is invalid.
  • 18 states led by TX (& backed by Trump admin) argue the mandate is central to the ACA, and w/o the penalty the ACA is unconstitutional.
  • 20 states + DC led by CA argue the mandate can be separated from the ACA so the law can still stand.

2012 vs. 2020

  • None of Pres. Trump appointees (Neil Gorsuch, Brett Kavanaugh, Amy Coney Barrett) were members of the Court when it ruled on the ACA previously.
  • The Court now has a 6-3 majority of Republican-appointed justices.
  • Some question if Justice Barrett’s 2017 critique of Chief Justice John Roberts’ 2012 opinion upholding the law means she will vote to strike it down, but she’s said she is “not hostile to the ACA.”


  • Big Picture: The quality, cost & availability of healthcare in America remains a hotly debated issue.
  • Timing: The fate of the ACA is being examined smack in the middle of a global pandemic with unique challenges.
  • Unknowns: While debates continue over the value of the law, roughly 17.5M more Americans have insurance now vs. before the ACA.


We won’t know the results of the case until next spring, and as late as June 2021.

If the law is struck down, the ripple effects are truly TBD.

If the law is upheld, there’s still a possibility of legislative changes as Democrats discuss adding a public option, and Republicans have promised to create a separate plan.

The incoming Congress could take actions (ex: eliminating the individual mandate or increasing the tax penalty to a nominal amount) which would influence how the Court ultimately rules. This is one of the reasons why the future of the Senate, with two tie-breaking seats in Georgia in a runoff for Senate party majority, matter so much.

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