The Supreme Court could be Trump's ACA nightmare
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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.
