SCOTUS rules to keep Obamacare in place

By Melissa Macaya, Meg Wagner and Melissa Mahtani, CNN

Updated 4:30 PM ET, Thu June 17, 2021
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4:26 p.m. ET, June 17, 2021

Here's a reminder of what the Affordable Care Act does – and how many people it impacts

From CNN's Tami Luhby

People sit down with an insurance adviser to sign up for health insurance through the Affordable Care Act in Miami, Florida, in 2015.
People sit down with an insurance adviser to sign up for health insurance through the Affordable Care Act in Miami, Florida, in 2015. Joe Raedle/Getty Images

The Supreme Court ruled today to keep the Affordable Care Act in place, meaning the law will remain intact and millions of Americans will still have health care coverage.

Here are key things to know about the law and its impact:

  • What is the Affordable Care Act? The Affordable Care Act, enacted in 2010, provides Americans with essential health insurance coverage. Also known as Obamacare, it makes health insurance affordable and available to more people. One of the law's most popular provisions is its strong protections for those with pre-existing conditions, including barring insurers from denying coverage or charging higher premiums based on people's health histories. Nearly 54 million Americans – or 27% of non-elderly adults – have pre-existing conditions that would make them uninsurable in the individual market prior to the law, according to the Kaiser Family Foundation.
  • Who does the law affect? Earlier this month, the administration announced that 31 million people have health coverage through the Affordable Care Act, including 11.3 million who had enrolled in Obamacare plans prior to the special enrollment period and 14.8 million who qualified for Medicaid expansion, which broadened the program to more low-income adults.
  • The pandemic's impact: Over the past year, as the coronavirus pandemic and resulting economic downturn have gripped the nation, the Affordable Care Act has served as a safety net for Americans who've lost their jobs — and their health insurance along with it — and for the uninsured seeking coverage. Enrollment in both the Affordable Care Act exchanges and Medicaid have risen since the outbreak began in March 2020.
  • GOP challenges: Originally, Americans were charged a monetary penalty if they did not sign up for coverage. In 2017, amendments to the Affordable Care Act removed the penalty by setting the amount to $0. This contradicted a 2012 case which held that the law’s individual coverage mandate was valid under Congress’ taxing power. Therefore, many Republicans argued that since the mandate was no longer tied to a specific tax penalty, the entire law should fall.
  • What the Biden administration has done: Since taking office, President Biden has moved to strengthen the Affordable Care Act and embed it even more deeply in the nation's health insurance system, including swiftly moving to overturn many of former President Trump's efforts to chip away at the law. Biden had already reopened enrollment in the federal Obamacare exchange and beefed up marketing, outreach and assistance in signing up for policies. Increasing the number of insured Americans by strengthening the Affordable Care Act was at the heart of Biden's health care campaign promises. And his administration is reversing Trump administration approvals of work requirements in Medicaid, which threatened to strip coverage from many people who gained it through Obamacare's expansion of the program.

CNN's Alyssa Kraus contributed reporting to this post.

Read more about ACA and the Supreme Court's ruling here.

2:07 p.m. ET, June 17, 2021

Health secretary on challenges to Obamacare: "Three strikes and you're out"

From CNN's Adrienne Vogt

Tom Williams/CQ Roll Call/AP
Tom Williams/CQ Roll Call/AP

US Health and Human Services Secretary Xavier Becerra said the Supreme Court dismissing a challenge to the Affordable Care Act provides “peace of mind” to millions of Americans.

“The Affordable Care Act has helped us build a better health care system in America. And we're going to continue to improve on that,” Becerra told CNN’s Ana Cabrera. 

The case marked the third time the court heard a significant challenge to Obamacare. 

“Well, in baseball, three strikes and you're out. I would think that all those opponents of the Affordable Care Act, they’ve not only struck out three times before the Supreme Court, but they've tried more than 70 times in Congress to dismantle it, and they failed,” Becerra said. “And so I think there's enough proof there that this thing is going to stand for quite some time. And Americans can have that peace of mind knowing that they can start talking about a better insurance plan, not about whether they're going to have insurance in the first place.” 

Becerra said the Supreme Court gave a “clear signal” about Obamacare and said history books will show the court “on the right side of history.”

“Sometimes, it feels like the Supreme Court is becoming very political as well. Here, I think they gave us a clear signal — ‘look, we understand when things are working, and show us that there's some constitutional foundation for undoing something that's worked for tens of millions of Americans,’” he said. 

Becerra said Congress can strengthen the law by permanently extending tax credits in President Biden’s American Rescue Plan. 

“If we extend that permanently, millions of Americans will continue to have their coverage,” he said. 

2:07 p.m. ET, June 17, 2021

Obama: "The Affordable Care Act is here to stay"

Alex Edelman/AFP/Getty Images
Alex Edelman/AFP/Getty Images

Former President Barack Obama took to Twitter today to react to the US Supreme Court's decision of uphold the Affordable Care Act, allowing health care coverage to continue for millions of Americans.

"This ruling reaffirms what we have long known to be true: the Affordable Care Act is here to stay," Obama tweeted.

2:07 p.m. ET, June 17, 2021

Biden applauds Supreme Court ACA decision, says it is a victory for Americans

From CNN's DJ Judd

Alex Wong/Getty Images
Alex Wong/Getty Images

In a statement Thursday, President Biden applauded the Supreme Court’s 7-2 decision to dismiss a challenge to the Affordable Care Act. 

“Today’s U.S. Supreme Court decision is a major victory for all Americans benefitting from this groundbreaking and life-changing law,” Biden writes. “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.”

The lawsuit challenging the ACA, colloquially “Obamacare,” was brought by Republican states opposing the law and supported by former President Trump — the court’s decision marks the third time the highest court in the land has upheld Obamacare.

“After more than a decade of attacks on the Affordable Care Act through the Congress and the courts, today’s decision – the third major challenge to the law that the U.S. Supreme Court has rejected – it is time move forward and keep building on this landmark law,” Biden wrote Thursday, pointing to provisions in his administration’s American Rescue Plan that expanded the ACA and the administration’s expanded enrollment period, which allows individuals to purchase health care through the exchanges through Aug. 15.

“Today’s decision affirms that the Affordable Care Act is stronger than ever, delivers for the American people, and gets us closer to fulfilling our moral obligation to ensure that, here in America, health care is a right and not a privilege," it adds.

2:06 p.m. ET, June 17, 2021

How some Democrats are reacting to the Supreme Court's ruling on Obamacare

From CNN's Alyssa Kraus

Following the Supreme Court's ruling this morning keeping the Affordable Care Act in place, some congressional Democrats weighed in on the move to keep former President Obama's landmark 2010 health reform law.

Remember: In its decision, the Supreme Court said the states challenging the law lacked the standing to sue and did not weigh in on the constitutionality of the Obamacare.

Still, it's a victory for supporters of the Affordable Care Act. Here's a look at how some congressional Democrats reacted:

House Speaker Nancy Pelosi

Senate Majority Leader Chuck Schumer

Sen. Elizabeth Warren

Sen. Patrick Leahy

2:06 p.m. ET, June 17, 2021

White House encourages people to enroll in health care after Supreme Court keeps ACA

From CNN's Elise Hammond

Angela Weiss/AFP/Getty Images
Angela Weiss/AFP/Getty Images

The White House and President Biden tweeted a reminder that the special enrollment period for the American Care Act is open until Aug. 15, after the Supreme Court ruled to keep the law in place.

"Today’s Supreme Court ruling once again underscored the incredible strength of the ACA. A record 31 million people have enrolled in health care through the law," the White House's tweet said, adding that 1.2 million more signed up using the special enrollment period.

Biden also tweeted saying the ruling was a "big win for the American people."

"With millions of people relying on the Affordable Care Act for coverage, it remains, as ever, a BFD. And it’s here to stay," Biden added.

BFD refers to a comment Biden made about health care reform, calling it a "big f-ing deal."

Read the tweet:

2:07 p.m. ET, June 17, 2021

The Biden administration had asked the Supreme Court to save Obamacare

From CNN's Ariane de Vogue and Tami Luhby

The Biden administration told the Supreme Court on Feb.10 that it should uphold the Affordable Care Act, reversing the position of the Trump administration that had urged the justices to strike down the entire law amid the coronavirus pandemic.

"Following the change in Administration, the Department of Justice has reconsidered the government's position," Deputy Solicitor General Edwin Kneedler told the court in a letter. The United States "no longer adheres to the conclusions" in a brief filed by the Trump administration.

Kneedler said the federal government now maintains that the law's individual mandate is constitutional, but even if the court disagrees, it should sever the mandate and allow the rest of the sprawling law to stand. Such a move would maintain the status quo, as the penalty associated with the mandate has been brought down to zero.

The case was argued on Nov. 10.

The letter marked one of the most substantive reversals the Biden administration has taken, but it did not mean the case would go away. It was originally brought by Republican attorneys general, and the Trump administration later joined on.

The challengers argued that the law's individual mandate is unconstitutional and that every other provision of the sprawling 900 page law should fall with it. California, joined by other Democratic-led states, as well as the House of Representatives, supports the law and has urged the justices to leave it in place.

The lawsuit concerned a move Congress made in 2017 to cut the penalty for those who lacked insurance to zero as part of the year-end tax overhaul. Critics raced to court arguing that the Supreme Court in 2012 had upheld the law under Congress' tax power, therefore, since the mandate is no longer tied to a specific tax penalty, it has lost its legal underpinning.

Read more about the letter and Biden's executive actions on health care here.

11:15 a.m. ET, June 17, 2021

SCOTUS leaving Obamacare in place sends message to "get this out" of the court, Andy Slavitt says

From CNN's Adrienne Vogt

Andy Slavitt, former acting administrator of the Centers for Medicare and Medicaid Services under the Obama administration, said the Supreme Court leaving the Affordable Care Act in place sends a message of “get this out of my court once and for all.”

“Certainly, I think a 7-2 ruling by a conservative court, which says you don't have standing, is in effect, 'get this out of my court once and for all.' And I think that's where this case belongs,” said Slavitt, who helped efforts to fix the troubled healthcare.gov rollout.

"I think it's great news for people have been in a whirlwind over the last 10 years, being told to just be nervous that their coverage might be snatched from them at any moment. So Americans can rest easier," said Slavitt, former Biden White House senior adviser for Covid-19 response.  

Slavitt said he has not heard directly from the President but has gotten texts from staffers.  

“The definitiveness of the ruling, I think, sends a very strong message to all those folks,” he said. 

2:06 p.m. ET, June 17, 2021

Pelosi calls the Supreme Court ruling a "landmark victory"

From CNN's Aditi Sangal

House Speaker Nancy Pelosi tweeted on the Supreme Court ruling keeping the Affordable Care Act in place.

She called it a "landmark victory for Democrats' work to defend protections for people with pre-existing conditions against Republicans' relentless efforts to dismantle them."

In a released statement, she added :

"Now, Democrats will continue our work to build on the transformational progress of the Affordable Care Act and make permanent the measures in the American Rescue Plan to dramatically lower the cost of health insurance premiums for people who purchase coverage on their own. For The People, we will lower health costs and prescription drug prices for all Americans.”