Supreme Court to decide fate of Obamacare, elevating healthcare as election issue

The Supreme Court has agreed to hear a case that could result in all of Obamacare being thrown out, bringing the future of the law to the forefront as a central campaign issue.

The decision to take up the case, announced on Monday, before the resolution of litigation in the lower courts will give Democrats ammunition with which to attack Republicans on the issue of healthcare. President Trump has not provided a backup plan for the law, which increased the number of insured by 20 million, should it be invalidated in court.

The Trump administration, which has told courts that the entire law should be thrown out, had asked the justices not to take up the question of the constitutionality of the law until the lower courts were done litigating the matter. Trump has been focusing his healthcare rhetoric on attacking “Medicare for all,” a plan championed by Democratic presidential candidate Bernie Sanders that would enroll everyone living in the United States into a government plan.

Democratic leadership in Congress has been squarely focused on defending Obamacare, a strategy it believes helped hand the party the House during the 2018 midterm elections. A recent Kaiser Family Foundation poll shows that the law, formally known as the Affordable Care Act, is more popular than ever, with 55% of voters viewing it favorably. Democrats have sought, in particular, to advertise the law’s rules that prohibit health insurance companies from turning away the sick or from charging them more than healthy people.

“For Americans who care about saving their health care, especially protections for Americans with pre-existing conditions, the Supreme Court’s decision to hear the case is a stark reminder of President Trump’s determination to end those protections — because any Democratic president would immediately drop this heartless Republican lawsuit,” Senate Minority Leader Chuck Schumer of New York said in a statement.

Four justices are needed to take up a case. The timing of the oral arguments hasn’t yet been announced, but it’s possible they would happen just ahead of 2020 elections.

While it’s not yet clear whether a decision would land before Election Day, Trump’s Democratic rival would be able to argue that the president is working to take away the law’s protections for preexisting conditions. If the law were to be thrown out, not only would millions lose insurance, but other popular policies would also end, such as the provision allowing for children to stay on their parents’ plans until age 26.

The case in question, Texas v. Azar, is the result of a lawsuit by Republican state officials who said that Obamacare must be struck down on the grounds that it lost a critical component when the 2017 GOP tax overhaul zeroed out the healthcare law’s fine on the uninsured. Republicans, who had the support of the Trump administration, said the fine had been central to Obamacare and that the rest of its provisions would not work and should not stand without it.

Judge Reed O’Connor, who was appointed by President George W. Bush, agreed with the GOP states, but the case was appealed to the 5th Circuit Court of Appeals. On Dec. 18, the appellate judges ruled 2-1 that the health insurance mandate was unconstitutional but that the rest of the law needed further analysis by the lower courts to see whether some parts could be separated out and others could not.

The 20 liberal states, along with the District of Columbia, that are defending Obamacare had urged the Supreme Court to take up the case this term, saying that leaving it undecided left too much uncertainty for patients and healthcare providers.

“Our health is the most precious resource we have — we should all be working to improve healthcare, instead of ripping coverage away from those most in need,” California Attorney General Xavier Becerra said of the Supreme Court’s decision to take up the case. “As Texas and the Trump administration fight to disrupt our healthcare system and the coverage that millions of people rely upon, we look forward to making our case in defense of the ACA. American lives depend upon it.”

Several medical and consumer groups, including AARP and the American Diabetes Association, agreed that the case should be taken up before litigation in the lower courts was final.

In a statement, the American Hospital Association pressed for an “expedited review,” which would land a decision ahead of the election.

“America’s hospitals and health systems and the patients we serve are ready to put this legal fight behind us — for good,” said Rick Pollack, president and CEO of the American Hospital Association.

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