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Biden Administration Urges Supreme Court to Uphold Affordable Care Act

WASHINGTON — In an unusual letter to the Supreme Court in a case already argued, the Biden administration told the justices on Wednesday that the federal government was switching sides in a challenge to the Affordable Care Act. Disavowing the position of the Trump administration, a Justice Department official urged the court to uphold the law.

The move was largely symbolic and will not end the case, which was brought by Republican state officials. When it was argued in November, a majority of the justices appeared inclined to uphold the bulk of the sprawling law, which was President Barack Obama’s defining domestic legacy.

“Following the change in administration,” the deputy solicitor general, Edwin S. Kneedler, wrote to the justices, “the Department of Justice has reconsidered the government’s position in these cases. The purpose of this letter is to notify the court that the United States no longer adheres to the conclusions in the previously filed brief of the federal respondents.”

The case, California v. Texas, No. 19-840, was brought by Republican officials who said the law’s mandate requiring health insurance coverage became unconstitutional after Congress in 2017 eliminated the penalty for failing to obtain coverage because it could no longer be justified as a tax.

The argument was based on a 2012 ruling in which Chief Justice John G. Roberts Jr., joined by what was at the time the court’s four-member liberal wing, said the mandate was authorized by Congress’s power to assess taxes.

The challengers went on to argue that without the mandate, the entire law must fall.

The Biden administration reversed course on both positions. The mandate, Mr. Kneedler wrote, was constitutional without a tax penalty.

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“Rather than imposing a new burden on covered individuals,” he wrote, “the 2017 amendment preserved the choice between lawful options and simply eliminated any financial or negative legal consequence from choosing not to enroll in health coverage.”

In any event, he wrote, the balance of the law should survive. Its other provisions, he wrote, were severable from the mandate.

Mr. Kneedler wrote that the government’s new position did not require new briefs or another hearing.

“Because oral argument was held and these cases were submitted three months ago, and because other parties have fully briefed both sides of the questions presented,” he wrote, “the United States is not requesting supplemental briefing.”

In the years since the enactment of the law in 2010, Republicans have worked hard to destroy it, and President Donald J. Trump relentlessly criticized it. But attempts to repeal it failed, as did two earlier Supreme Court challenges, in 2012 and 2015. With the passing years, the law grew in popularity and was woven into the fabric of the health care system, and its future has appeared increasingly secure.

A ruling in the case is expected by June.

Striking down the Affordable Care Act would expand the ranks of the uninsured in the United States by about 21 million people — a nearly 70 percent increase — according to recent estimates from the Urban Institute.

The biggest loss of coverage would be among low-income adults who became eligible for Medicaid under the law after most states expanded the program to include them. But millions of Americans would also lose private insurance, including young adults whom the law allowed to stay on their parents’ plans until they turned 26 and families whose income was modest enough to qualify for subsidies that help pay their monthly premiums.

A ruling against the law would also doom its protections for Americans with past or current health problems — known as pre-existing conditions. The protections bar insurers from denying them coverage or charging them more for it.

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