High court seems likely to leave health care law in place

Supreme Court to hear arguments Tuesday in case that threatens Affordable Care Act

He later said it was "fairly clear" that precedent allowed for simply cutting out the mandate, questioning the Texas lawyer heading the anti-ACA side on how he can argue around that precedent.

As much as he has attacked the ACA, trying to cut related budgets and services, Trump has not yet offered alternatives that would cover those losing insurance if the law is struck down.

The Supreme Court is unlikely to kill Obamacare, as Republicans challenged the legality of the Affordable Care Act's individual mandate Tuesday at the high court for the third time in hopes the 6-3 conservative majority would finally do away with President Obama's signature law. The 2012 Supreme Court ruling upheld most Obamacare provisions including the individual mandate.

The case comes to a court that now has three justices appointed by President Donald Trump: Neil Gorsuch, Brett Kavanaugh and Amy Coney Barrett, who joined the court late last month following her hurried nomination and confirmation to replace the late Justice Ruth Bader Ginsburg.

Such a decision would also likely strip health insurance from tens of millions of Americans who have gained insurance since the law's coverage expansion began in 2014.

Previous judges in the case have mostly sided with Republicans.

Since taking office in 2017, Trump has tried to undermine the ACA, first eroding one key provision through legislation, and then seeking to cancel it altogether, backing a lawsuit by Texas and several other Republican-led states. And if it does, will it then decide the rest of the healthcare law can not stand without it? Texas-based U.S. District Court Judge Reed O'Connor in 2018 ruled that Obamacare was unconstitutional as now structured in light of a Republican-backed change made by Congress a year earlier.

In the dispute Tuesday, the court is considering if the individual mandate's $0 tax penalty does make the health care law as a whole illegal, or if the individual mandate can be severed from the rest of the ACA.

The case turns on a change made by the Republican-controlled Congress in 2017 that reduced the penalty for not having health insurance to zero.

Roberts has twice voted to uphold core parts of the law, in 2012 and in a 2015 ruling that backed crucial tax credits in the law. In California, almost 17 million Californians with pre-existing conditions could face higher health costs or loss of benefits, 5 million Californians could lose health insurance coverage completely and California would lose $27 billion to cover health care costs for low-income families.

After serving as President Barack Obama's vice president for eight years, Biden has pledged to build on the Affordable Care Act while championing a "public option" that would allow more people to opt into government-sponsored health insurance even as millions of others could stick with their current, usually employer-based coverage. But the 5th Circuit stopped short of striking down the law. The case could also be rendered irrelevant if the new Congress were to restore a modest penalty for not buying health insurance. And they're right in one respect: At the time the law was being debated, the mandate was seen as essential to launching the new state markets where people not covered by large employers' group plans would shop for insurance.

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