Supreme Court’s latest ruling for Obamacare could be final death knell in conservative crusade against law

The US Supreme Court’s ruling on Thursday rejecting the latest GOP-led attempt to overturn the Affordable Care Act marked an end to a years-long effort on the right to repeal the Affordable Care Act (ACA).

Across traditional and social media, supporters and the law’s most ardent defenders celebrated Obamacare’s most resounding victory at the Supreme Court level since the Court declared the individual mandate constitutional in 2012.

In a 7-2 ruling, the court dismissed a challenge supported by numerous Republican-led states as well as officials from the Trump administration that sought to overturn the entirety of the law on the grounds that the law was unconstitutional and that the ACA’s individual mandate was an improper use of Congress’s taxation powers.

The decision, penned by Justice Stephen Breyer, dismissed the challenge on the basis that Texas, which led the lawsuit, and other GOP states did not have proper legal standing to bring the case having not suffered injury from the tax provision.

Health and Human Services Secretary Xavier Becerra, who led the legal fight to defend Obamacare as California’s attorney general before his confirmation to HHS, shared his elation on MSNBC, exclaiming: “Thank God we have common sense prevailing in the Supreme Court!”

“As a Member of Congress, I helped draft and pass the ACA. As the Attorney General of California, I took this case all the way to the Supreme Court. And now, as Secretary, I will continue to stand up and stand with you to protect access to affordable health care,” Mr Becerra added in a statement released by HHS.

President Joe Biden, who presided over the Senate as it voted to send the ACA on a party-line vote to former President Barack Obama’s desk in 2009, released his own statement from the White House celebrating the news.

“Today’s U.S. Supreme Court decision is a major victory for all Americans benefitting from this groundbreaking and life-changing law. It is a victory for more than 130 million Americans with pre-existing conditions and millions more who were in immediate danger of losing their health care in the midst of a once-in-a-century pandemic,” he said.

Adding of the continued GOP resistance to the bill, the president continued: “After more than a decade of attacks on the Affordable Care Act through the Congress and the courts...it is time [to] move forward and keep building on this landmark law.”

Whether the country can move forward from the passage of Obamacare — more specifically, whether Republicans are done trying to overturn the now decade-old law — is less clear.

Texas Attorney General Ken Paxton, who led the charge of 20 GOP-led states in the law’s latest challenge, has already vowed to continue the fight against Obamacare in the courts, though how much success he will have is an open question.

“Seven justices decided to avoid the question of the constitutionality by limiting [the Court’s] ruling to a decision on its standing,” he said in a statement Thursday.

“As your Attorney General, I will continue to fight this law – in fact, I have only just begun,” added Mr Paxton, who is himself mired in investigations by the FBI and Texas State Bar.

While the legal battles over the law may continue for some time, the law is becoming increasingly unlikely to be tossed out through those means, thanks to three decisions at the Supreme Court in the law’s favor.

The real question now for conservative opponents of the law is whether to continue efforts through Congress to repeal the law. In 2017, the GOP during former President Donald Trump’s first year in office came up with the American Health Care Act (2017), an effort to repeal numerous parts of the ACA while making major changes to Medicaid.

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The effort turned into a disaster for Republicans, who saw no Democratic support for the bill while their caucus fractured in the House, dooming the legislation. The GOP-led Congress eventually abandoned its efforts to repeal Obamacare, at least for the duration of Mr Trump’s presidency, after a so-called “skinny repeal” of the law failed in a dramatic 11th-hour vote wherein Sens John McCain, Susan Collins and Lisa Murkowski joined with Democrats to kill the GOP bill.

Such a scenario reveals the risk for Republicans in pursuing another repeal of the law. Many GOP lawmakers, particularly in purple states, will remember the stinging losses their party suffered in the 2018 midterms, losing dozens of seats in the House while allowing Democrats to minimize losses in the Senate despite the opposition party facing an extremely unfavorable map. The cause of the losses were clear: In exit polls gathered by NBC News, four in ten voters said health care was the top issue that drove them to the ballot box that year.

One of the main issues blamed for the GOP health care efforts’ failures are preexisting conditions, which a 2019 analysis by the Kaiser Family Foundation found affect roughly 54 million Americans in a way that would make them completely uninsurable should Obamacare’s ban on charging patients more for such conditions be repealed. Republicans found themselves on the defensive over the issue as the health care debate raged, with some insisting that their plans protected such Americans despite evidence pointing to the contrary.

Though Republicans remain in the minority in both chambers of Congress, the party could theoretically push forward with a new legislative effort to repeal the law should they take control of the House and Senate next year.

“If Republicans retake the White House, Senate and US House, they will undoubtedly try to repeal/scale back protections of the ACA,” said Rob Davidson, executive director of the Committee to Protect Health Care.

“[W]e must continue to organize and stay engaged on these issues, so taking away health care from millions of Americans, my patients, becomes too much of a red line for extremist politicians to touch it,” added Mr Davidson, an emergency room physician, in an interview with The Independent.

While Democrats remain vigilant and on the lookout for the next GOP push to roll back the ACA, some Republicans who were intimately involved with the last effort are signaling that they are less than enthusiastic about trying it again.

“It’s been my public view for some time that the Affordable Care Act is largely baked into the health care system in a way that it’s unlikely to change or be eliminated,” Sen Roy Blunt of Missouri told The Hill.

“Just practically speaking, you need 60 votes in a Republican Senate, a Republican president, right?” added Sen Bill Cassidy, according to The Associated Press. “And we’ve tried that and were unable to accomplish it.”