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Supreme Court to Review ACA Case

The Supreme Court on March 2 announced it will review Texas v. U.S., a decision of the U.S. Court Appeals for the Fifth Circuit on the constitutionality of the Affordable Care Act’s (ACA’s) individual mandate. The outcome will decide the fate of the law.

The announcement comes after a failed push from Democratic-led states and the House of Representatives for the Supreme Court to expedite the case’s review. America’s Essential Hospitals, in coalition with other national hospital associations, filed an amicus brief in January urging the court to review the decision before the current term ends in June. The Supreme Court now is expected to hear the case during its fall term, which begins in October, with a decision likely next year.

How We Got Here

Congress in 2017 reduced the tax penalty associated with the individual mandate to zero but did not eliminate the mandate altogether. A group of Republican-led states filed suit to challenge the constitutionality of the individual mandate, arguing that it no longer falls under Congress’ taxing power without a tax penalty.

In 2018, the U.S. District Court for the Northern District of Texas agreed with this argument, deeming the individual mandate unconstitutional. The judge also ruled that the individual mandate is inseverable from the rest of the ACA, rendering the entire law unconstitutional.

The case was appealed to the U.S. Court of Appeals for the Fifth Circuit. In a December 2019 decision, the Court of Appeals agreed with the District Court that the individual mandate is unlawful but declined to rule on the mandate’s severability from the rest of the ACA, leaving the fate of the law unclear.

The Court of Appeals sent the case back to the District Court to review more thoroughly which parts of the ACA could survive without the mandate. In response to the decision, the Democratic-led states filed a petition asking the Supreme Court to review the case and dismiss the Court of Appeals’ ruling.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Emily Schweich is a communications manager at America's Essential Hospitals.

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