It’s finally official: the Affordable Care Act (aka “Obamacare”) is constitutional. The opponents of the ACA have now had three bites at the apple:
- National Federation of Independent Business v. Sebelius, 567 U.S. 519 (2012), in which the Supreme Court found constitutional the penalty provisions of the ACA as a part of the legitimate “taxing power” of the United States Congress.
- King v. Burwell, 576 U.S. 473 (2015), in which the Supreme Court held that the outlay of premium tax credits was constitutional both in those states with exchanges established directly by a state, and those where the exchanges were established by the federal government.
- California v. Texas, No. 19-840 (2021), in which the Supreme Court now holds that states like Texas did not have “standing” to bring their latest challenge to the ACA, which had to do with the taxing power of the Congress after the penalty for not having health insurance had been set to $0.
Don’t worry if you don’t understand this. Hardly anyone without a law degree understands it. It has to do with “federalism” and the commerce clause and what the federal government is allowed to do and what it has to cede to the states. It’s highly technical.
The point is that the opponents of the ACA have now taken every shot they can at it, including neutering the penalty provisions, and they haven’t succeeded.
The history is actually very similar to that of Social Security, which was also challenged back in 1937 as an unconstitutional exercise of the legislative powers of the Congress (see, for example, Helvering v. Davis, 301 U.S. 619 (1937) and Steward Machine Company v. Davis, 301 U.S. 548 (1937)).
The Republicans have not yet introduced a legitimate alternative to the ACA because — as has been noted on many previous occasions — the “individual mandate” was their idea. It was their response to the Clinton health care proposals, and I guess that’s all they got. They shot their wad and never managed to reload.
In the meantime, needless to say, we’re still waiting for #45, the former guy, to unveil his “amazing” health care plan.