Supreme Court Rejects Texas-Led Claim to Invalidate Affordable Care Act

American Psychiatric Association

Mon Jun 21, 2021

The U.S. Supreme Court last week upheld the Affordable Care Act (ACA) and ruled against the state of Texas and other plaintiffs in its challenge to the ACA, saying the plaintiffs had no legal standing to bring the case.The ruling puts to rest the latest legal challenge to the ACA brought by Republican activists and lawmakers seeking to weaken or invalidate altogether the landmark health care reform signed by President Barack Obama in 2010.The suit, California et al. v. Texas et al., was brought by the state of Texas and 19 other states. It revolved around the “severability” of one component of the ACA—the individual mandate, which had required uninsured individuals who did not sign up for health insurance to pay a penalty—from the rest of the law. Texas and the other plaintiffs argued that since Congress amended the law in 2017 to eliminate the penalty associated with the mandate, the entire ACA was therefore unconstitutional.In 2019, APA signed a friend-of-the-court brief rebutting the Texas argument and stating that wholesale invalidation of the ACA would “have a devastating impact on patients and the American health care system.”In its 7-2 decision, the Supreme Court ruled that the plaintiffs did not have legal “standing” to bring the case because they did not prove that they had been injured by the law. Writing for the majority, Justice Stephen Breyer wrote, “[W]e conclude that the plaintiffs in this suit failed to show a concrete, particularized injury fairly traceable to the defendants’ conduct in enforcing the specific statutory provision they attack as unconstitutional. They have failed to show that they have standing to attack as unconstitutional the Act’s minimum essential coverage provision.”Marvin Swartz, M.D., a member and past chair of the APA Committee on Judicial Action, said APA joined the 2019 amicus brief “out of grave concern that yet another legal assault on the ACA would do irreparable harm to our patients.”Swartz told Psychiatric News that numerous studies have documented improved insurance coverage for people with mental illness and substance use disorders under the ACA. “We are heartened that the court held 7-2 that the plaintiffs in the case had no standing to bring the suit,” he said. “While decided on fairly narrow and technical grounds, we are hopeful that the decision will put challenges to the ACA behind us and instill further confidence in this cornerstone of equitable and affordable health care.”APA CEO and Medical Director Saul Levin, M.D., M.P.A., welcomed the court’s ruling. “With more Americans seeking mental health and substance use services, the elimination of coverage would impact millions of Americans,” Levin said. “The court made the right decision. APA will continue to be vigilant about protecting the rights of our patients guaranteed by the ACA.”