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Illustration: Sarah Grillo/Axios

The Supreme Court’s next big Affordable Care Act case could be a huge political problem for President Trump.

Why it matters: The Trump administration will spend the next several months urging the court to strip away some 20 million people’s health insurance and to throw out protections for pre-existing conditions. And it may all come to a head just before Election Day.

Driving the news: The court said yesterday that it will hear the challenge filed by Republican attorneys general, and supported by the Trump administration, that aims to strike down the entire ACA.

  • The move was a surprise: Machinations in the lower courts had seemed likely to push a Supreme Court appeal well past the election.

What’s next: Oral arguments in the case haven’t been scheduled yet, but following the court’s standard timeline, there’s a decent chance those arguments could fall in October — just weeks, or potentially even days — before Election Day.

  • Election-eve arguments over the fate of 20 million people’s health care coverage would be a particularly great gift for Democrats, but even if they fall after Nov. 3, this case is still a gift.

Where it stands: Polls consistently show that health care is among voters’ most important issues in 2020, and if this case becomes a big part of that debate, it's likely to disproportionately benefit Democrats.

  • Opposition to the health care law doesn’t rile up the Republican base the way it used to.
  • But as we saw during the repeal-and-replace saga of 2017 and then in the 2018 midterms, threats to those protections definitely motivates Democrats.
  • The ACA as a whole is now popular, and some of its main provisions — like guaranteed coverage for people with pre-existing conditions — have always been popular.

The Justice Department has been advocating for the end of the ACA for almost a year and had urged the courts to strike down protections for pre-existing conditions before that. But the case, despite its implications, hadn’t really penetrated the 2020 conversation so far.

  • That’s likely to change as we head into a general election with a Supreme Court case looming.
  • Trump has repeatedly brushed aside questions about pre-existing conditions, saying his administration will protect patients who have them.
  • But neither the White House nor congressional Republicans have ever put forward a plan that would ensure the same level of protection as the ACA.

Reality check: This will be the third time the Supreme Court has held the ACA’s life in its hands.

  • And though the court has gotten more conservative over that time, all five of the justices who voted to uphold the law in 2012 are still there.

The bottom line: “Regardless of the date of oral argument, the Democratic candidate will — and should! — use this case to bludgeon President Trump at every turn,” University of Michigan law professor and ACA legal guru Nicholas Bagley tweeted.

Go deeper

Barrett defends past writings: "I am not hostile to the ACA"

Supreme Court nominee Judge Amy Coney Barrett told the Senate Judiciary Committee on Tuesday that she's not "hostile" toward the Affordable Care Act or any statute passed by Congress, defending a past writing in which she criticized Chief Justice John Roberts' opinion upholding the law.

Why it matters: Democrats' central message throughout the confirmation fight has been that Barrett was nominated in order to help President Trump and conservatives dismantle the ACA when the Supreme Court hears a lawsuit against it on Nov. 10.

Oct 12, 2020 - Politics & Policy

Harris calls Barrett confirmation hearing "illegimate" and "reckless"

Sen. Kamala Harris condemned the confirmation process for Supreme Court nominee Amy Coney Barrett as both "illegitimate" and "reckless," citing the more than 9 million Americans who have already voted in the 2020 election and the coronavirus risks that have prompted the Senate to suspend all other floor business.

Why it matters: Harris, who is a member of the Senate Judiciary Committee in addition to being Joe Biden's running mate, encapsulated the Democrats' strategic message for the confirmation fight on the first day of Barrett's hearings on Monday.

How Amy Coney Barrett would change the way the Supreme Court works

Illustration: Eniola Odetunde/Axios

Appointing three Supreme Court justices will likely be President Trump’s most important achievement, and Judge Amy Coney Barrett may well be the most important of the three.

Why it matters: Barrett would transform the court’s internal politics, handicapping Chief Justice John Roberts and establishing a new center of gravity on the right. Her presence would force a whole new set of strategic calculations among the justices — and those calculations will shape the law of the land for a generation.