GOP Tries Again to Get High Court to Ax Obamacare

The Supreme Court considers the latest challenge to the Affordable Care Act on Tuesday

COVID-19 would become America's newest pre-existing condition, for more than 10 million people who have tested positive so far.

All eyes will be on the newest justice, Amy Coney Barrett, whose appointment Trump rushed through in October, saying he wanted her in position to help decide any election cases as well as the ACA case. However, Kavanaugh voting in favor of severing that provision - coupled with the expectation that Chief Justice John Roberts will uphold the law, as he has in the first two challenges - would let the rest of the law go untouched. Roberts and Justices Stephen Breyer, Elena Kagan and Sonia Sotomayor have voted to uphold it.

But without any replacement plan prepared by the Trump administration, the impact of doing so could be devastating to 20 million Americans who would likely lose their insurance coverage.

But Texas Atty. Gen. Ken Paxton filed a suit contending that revoking the tax penalty meant the entire law must fall.

Congress reduced the penalty to zero, and now, in a lawsuit filed by Texas and several other Republican-led states, they want the Supreme Court to declare the entire ACA unconstitutional, arguing it can not stand without the individual mandate.

The speech comes the day Supreme Court justices are hearing oral arguments in the case that seeks to overturn the landmark health reform law. "What President Trump said, and what the congressional leadership said, and virtually everybody said when they enacted this amendment in 2017.is they were repealing the mandate" by getting rid of the penalty.

Kavanuagh said that looking at the court's precedents on severability, it seems "fairly clear" that the mandate could be struck down while the other ACA provisions are left untouched.

GOP lawmakers in 2017 did manage to effectively cancel the tax penalty under the law for people who refused to have insurance.

Senate Democrats said last month they feared Barrett would cast a key vote to strike down the law, but she signaled she did not see a reason for striking down a broad law because of one flawed provision.

By contrast, just about all the actors in the health industry - from the American Medical Association, to hospitals across the country, to the insurance industry - have weighed in urging the Supreme Court to preserve the law.

Billions of dollars of federal aid to states to allow them to expand eligibility for Medicaid would also be eliminated, forcing states to pare back their healthcare safety nets.

Senior Trump administration officials - including Seema Verma, who oversees Medicare, Medicaid and the marketplaces - and government lawyers have repeatedly hailed the stability of the marketplaces in recent years, noting enrollment and premium numbers.

But most of the groups that originally objected to the ACA in the earlier cases - including business groups - this time have not joined the challenge.

Shortly after that decision, when the court issued an opinion in a case involving robocall regulation, Justice Brett Kavanaugh made a similar point. Majority are adults working in jobs that don't pay all that much, and don't come with health insurance.

"Tens of millions of [previously uninsured] people who gained coverage under the law's various pathways could lose that coverage overnight", says Renuka Tipirneni, a primary care physician and health policy researcher at the University of MI hospital. Health care accounts for about one-fifth of the USA economy.

Indeed, the scope of the ACA's protections for all Americans is so wide that most people now take them for granted, Tipirneni says. "I am joining my colleagues in defending the ACA in front of the U.S. Supreme Court and protecting access to health care for millions of families across the country".

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