The U.S. Supreme Court issued a third opinion this week concerning the Affordable Care Act (ACA), also known as Obamacare, protecting it once again from judicial challenge. When the law was passed in 2010, it included a mandate for every U.S. adult to purchase health insurance or face a monetary penalty. In the first ACA legal challenge, the U.S. Supreme Court ruled in 2012 that the monetary penalty was technically a tax and within Congress' taxing authority and therefore constitutional. During the Trump administration, Congress revised the law and reduced the "tax" penalty to $0 in 2017.
Texas, and 17 other states including Missouri, then challenged the ACA as being unconstitutional, claiming that without the "tax" provision, Congress did not have the power to enact a mandate for every adult to carry health insurance, and that without the mandate, the entire Act must fail. By a vote of 7-2, the U.S. Supreme Court disagreed. The Court ruled that Texas and the other challengers do not have "standing" to sue, because they face no penalty for failing to comply with the mandate. Without a penalty for failure to carry health insurance, the mandate is unenforceable and there is no issue for the Court to decide, because Texas and the individual plaintiffs do not have an injury "traceable to the defendant's [read: Congress'] alleged unlawful conduct." Millions of Americans have obtained health insurance coverage through the provisions of the ACA.