Why Democrats Want the Supreme Court to Act Quickly on a Case That Could End Obamacare

A group of Democratic state officials and the Democratic-led House of Representatives on Friday asked the Supreme Court to take up a case with the potential to wipe away the entire Affordable Care Act.

The appeal asks the court to review the case quickly — during the court’s current session — a schedule that would allow the outcome to be final before the 2020 presidential election.

“Because of the practical importance of the questions presented for review and the pressing need for their swift resolution by this Court, petitioners respectfully request that the Court consider the petition on an expedited schedule,” says a filing brought by 20 states and the District of Columbia.

It may seem paradoxical for Democrats to seek a swift resolution to a case that could upend a signature achievement of the Obama presidency. But keeping the case alive — and in the public eye — may help them politically, by sharpening the contrast between the two parties on an issue of great concern to voters. Democrats could return to themes that helped propel them to a House majority in 2018, promising to preserve the health law’s popular protections for Americans with pre-existing health conditions.

The case was originally brought by a group of Republican state officials, who argued that changes to the Affordable Care Act made by Congress in 2017 rendered the law’s requirement that most Americans obtain health insurance unconstitutional. The Trump administration took the side of the state officials, and together they have argued in court that, without the so-called individual mandate, the rest of the major health care law should also be erased.

A Federal District Court judge in Texas agreed, ruling all of Obamacare invalid, but postponed the effects of his ruling until the case could be appealed. In that ruling last month, the Fifth Circuit Court of Appeals found that the mandate could not remain, but declined to rule on what should happen to the remainder of the health law, asking the lower court to reconsider the question in more detail.

Under a normal process, the case would take months, if not years, to reach the Supreme Court. But the Democratic states and the House, which intervened in the case to defend the health law, are asking the Supreme Court to review the Fifth Circuit’s ruling immediately.

There are effectively three paths forward for the case. The Supreme Court could reject it, letting the lower courts continue their work. It could accept it, and grant the litigants’ request for “expedited review,” hearing the case this session. Or it could accept the case on its typical schedule, which would most likely mean oral arguments and a ruling in its session that begins in the fall. Four justices would need to agree to accept the case, but it would take a majority vote of five to speed up the case’s consideration.

If the current lower court ruling from Texas is ultimately upheld, the case could have major consequences throughout the health care system. Estimates from the Urban Institute suggest that around 20 million more Americans would become uninsured. And a wide range of federal health policies, including consumer protections, payment reforms, drug approval processes and fraud penalties, would have to be unwound.

The Supreme Court has already ruled in two major cases challenging core provisions of the health law. In both, it left the bulk of Obamacare in place. The five justices who made up the majority in one key earlier case — centered on the law’s individual mandate — are still on the court.

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