|Principal Writer:||Barry Shatzman|
|Understanding The Issue|
|Legislative & Executive Acts|
|What You Can Do|
Reported NewsHealth Care Policy
Related BillsConcurrent Resolution FY2017
Related Court Cases(2018) California v. Texas (prev. Texas v. US)
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Mandate constitutional. States can refuse Medicaid Expansion
In 2012 the Supreme Court ruled in NFIB v. Sebelius that the mandate to purchase health care insurance is constitutional.
It also ruled, however, that the federal government could not compel states to expand their Medicaid coverage.
Click here for our discussion of NFIB v. Sebelius.
Court allows payments required by law to stop
In May 2016, a federal judge ruled in House of Representatives v. Burwell that payments of Cost-Sharing Reduction Subsidies by the Obama Administration were unconstitutional, because Congress had not appropriated the money.
The Obama Administration appealed, and was allowed to continue making the payments.
Trump continued the payments, then stopped them
The Trump administration initially continued to make the payments, but announced in October 2017 that the payments would be stopped.
Though several states sued the Trump administration to keep the payments, a federal judge ruled in the Trump administration's favor - allowing the payments to stop.
Taxpayers still pay
Insurance companies still are required by law to provide the reductions (on silver level plans) only). They can increase the premiums on silver level plans to make up for the difference. But since the cost for those who receive subsidies if fixed, based on their income, the federal government will pay the difference.
This case originally was House v. Burwell (Sylvia Matthews Burwell was Secretary of Health and Human Services under Pres. Barack Obama). The name changed to House v. Price when Tom Price became the Secretary under Pres. Trump. It then changed to House v. Azar when Alex Azar replaced Price.
Republicans challenge subsidies from federal exchanges
When ObamaCare was enacted, it was assumed that each state would create its own insurance exchange for its residents to buy health care insurance. For various reasons, however, several did not. Those states use the federal exchange, healthcare.gov.
This lawsuit challenged a phrase in the law that implied premium subsidies should be available only in states that established their own exchange.
The Supreme Court ruled that subsidies are valid regardless of how a state set up its exchange.
Republicans say ObamaCare unconstitutional without mandate
One provision of the 2017 tax law was the elimination of a penalty for not having health care insurance.
In 2018, a group of Republican-led states filed a lawsuit claiming that, in the effective absence of the mandate, the entire ObamaCare law was unconstitutional.
A federal judge in Texas ruled in favor of the Republican states. After an appeal resolved little, the Supreme Court agreed rule on the case after the 2020 presidential election.
In June 2021, the Supreme Court dismissed the case (which had its name changed to California v. Texas), keeping ObamaCare intact as the nation's health care policy.
Click here to read our explanation of California v. Texas.