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What are the details of the California v. Texas case and how does it threaten the ACA?

Read on as we breakdown the key takeaways from the case and what it means for the future of ACA.

  • The future of the Affordable Care Act (ACA) is unclear as the U.S. will once again consider the constitutionality of the legislation. Supreme Court in California v. Texas. Oral arguments are set for Tuesday, 10 November 2020.
  • This continuing lawsuit challenges the minimum necessary coverage clause of the ACA (known as the individual mandate) and raises concerns about the survival of the entire statute.
  • If the Supreme Court agrees that all or most of the ACA must be reversed, as the federal government now claims, the most far-reaching consequences, affecting almost every American in some way, will happen. As the ACA went into practice, the number of non-elderly people who are uninsured declined by 18.6 million from 2010 to 2018.
  • If the Supreme Court finds that the individual mandate is unconstitutional and invalidates only that clause, the functional outcome, without an enforceable mandate, would be the same as the ACA is today. If the Supreme Court adopts the stance taken during the trial court trials by the federal government and invalidates the individual mandate as well as the guarantees for citizens with pre-existing conditions, so federal premium subsidy reimbursement and the extension of Medicaid would remain and whether to reinstate the insurance protections will be up to the states.
  • The ACA remains in place for now. The trial court’s original decision that the entire ACA should be invalidated was never implemented and was set aside by the 5th Circuit.
  • Although the appeal is pending, the Trump Administration has stated that it plans to continue implementing the ACA.
  • For now, the only assurance for the ACA is the ongoing confusion about its survival, as the Supreme Court’s decision in the case could come as late as June 2021.

The Supreme Court could still decide to strike down part or all of the law next year, but many believe that is unlikely after justices listened to oral arguments earlier this month.

“The reason the law was impossible or extremely difficult to dismantle, many experts said, is because it is so deeply baked within the American health care system. So much so that it would be difficult for consumers and insurers to imagine the health care landscape after it was gone.”

For more information on the ACA and California v. Texas, please visit:

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