The Supreme Court saved the Affordable Care Act yet again on Thursday, tossing out a Republican lawsuit that sought to overturn former president Barack Obama’s signature legislation.
The 7–2 decision brought together the court’s liberal wing and several of its more conservative members, including the two newest justices confirmed under former president Donald Trump, Justices Amy Coney Barrett and Brett Kavanaugh.
The majority concluded that Texas and the other Republican state attorneys general who sued lacked standing to bring the case at all, a ruling that brought the yearslong fight to an end without delving into the substance of the latest challenge to the healthcare law. Justice Stephen Breyer wrote the opinion, which was also joined by Chief Justice John Roberts Jr. and Justices Clarence Thomas, Sonia Sotomayor, and Elena Kagan.
The ACA’s many provisions that transformed the US healthcare system will remain intact — including insurers being blocked from denying coverage to people with preexisting conditions, regulated individual insurance markets, and an expansion of Medicaid plans to millions of people with low incomes.
To establish standing, a party has to show that they suffer an injury traceable to the issue at hand. The Texas lawsuit centered on the individual mandate portion of Obamacare, a tax on people who decline to purchase health insurance, which did not directly affect state governments at all. The Republican states tried to get around this by arguing that encouraging people to sign up for health insurance causes extra paperwork costs for states as an employer. “Those forms don’t produce themselves,” then–Texas solicitor general Kyle Hawkins argued before the Supreme Court in November.
The court wasn’t having it. During last year’s hearing, Justice Elena Kagan said the Texas argument would “explode” standing doctrine
The Republican states tried to argue that the individual mandate penalty — despite being $0 — increased their financial burden by driving more people to join state medical insurance programs. But the court forcefully rejected that argument.
“Neither logic nor evidence suggests that an unenforceable mandate will cause state residents to enroll in valuable benefits programs that they would otherwise forgo,” says the decision.
The justices ruled that granting standing in a case like this would essentially give the courts a blank check to overturn legislation. “It would threaten to grant unelected judges a general authority to conduct oversight of decisions of the elected branches of Government,” says the ruling.
The Supreme Court on Thursday unanimously ruled that Philadelphia may not bar a Catholic agency that refused to work with same-sex couples from screening potential foster parents.
Chief Justice John G. Roberts Jr., writing for six members of the court, said that since the city allowed exceptions to its policies for some other agencies it must also do so in this instance. The Catholic agency, he wrote, “seeks only an accommodation that will allow it to continue serving the children of Philadelphia in a manner consistent with its religious beliefs; it does not seek to impose those beliefs on anyone else.”
The decision, in the latest clash between anti-discrimination principles and claims of conscience, was a setback for gay rights and further evidence that religious groups almost always prevail in the current court.
Philadelphia stopped placements with the agency, Catholic Social Services, after a 2018 article in The Philadelphia Inquirer described its policy against placing children with same-sex couples. The agency and several foster parents sued the city, saying the decision violated their First Amendment rights to religious freedom and free speech.
Lawyers for the city said the case, Fulton v. City of Philadelphia, No. 19-123, was an easy one. When the government hires independent contractors like the Catholic agency, they said, it acts on its own behalf and can include provisions barring discrimination in its contracts.
Lawyers for the agency responded that it merely wanted to continue work that it had been doing for centuries, adding that no gay couple had ever applied to it. If one had, they said, the couple would have been referred to another agency.
A unanimous three-judge panel of the United States Court of Appeals for the Third Circuit, in Philadelphia, ruled against the agency. The city was entitled to require compliance with its nondiscrimination policies, the count said.
The case was broadly similar to that of a Colorado baker who refused to create a wedding cake for a same-sex couple.
In 2018, the Supreme Court refused to decide the central issue in that case, Masterpiece Cakeshop v. Colorado Civil Rights Commission: whether businesses may claim exemptions from anti-discrimination laws on religious grounds. It ruled instead that the baker had been mistreated by members of the state’s civil rights commission who had expressed hostility toward religion.
The foster care agency relied on the Colorado decision, arguing that it too had been subjected to hostility based on anti-religious prejudice. The city responded that the agency was not entitled to rewrite government contracts to eliminate anti-discrimination clauses.