Efforts to repeal the Affordable Care Act (ACA) have reemerged in the news recently due to a pending lawsuit challenging its constitutionality.

This week, the 5th Circuit Court of Appeals heard oral arguments in the high-profile lawsuit backed by the Trump administration seeking to overturn the ACA. The appeals court is reviewing a federal trial court's decision from last December finding the ACA's individual mandate to be unconstitutional. Texas and a coalition of other Republican-led states filed a lawsuit in February of 2018 seeking to overturn the law, arguing that since Congress in 2017 repealed the individual mandate financial penalty, the remaining mandate cannot be upheld as part of Congress's power to tax. The Trump administration last year declined to defend parts of the law that ensure people with preexisting health conditions cannot be denied or charged more for health insurance. The administration expanded their position in March, calling on the 5th Circuit to confirm the trial court's decision.

California and 19 other Democratic-led states initially led the legal defense against the ACA lawsuit, and the House of Representatives joined the defense this year. Fifth Circuit judges last week asked for supplemental briefs on whether these states and the House of Representatives have standing to intervene in the case. Legal experts believe it unlikely the court would rule that neither have standing, though that is also uncertain.

While the path forward is obviously unknown, it is considered likely that the lawsuit will eventually make its way to the Supreme Court; the high court has upheld the ACA twice since first passing Congress in 2010.

Clinical Topics: Cardiovascular Care Team

Keywords: Health Policy, Patient Protection and Affordable Care Act, Medicaid, Public Health, Preexisting Condition Coverage

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