Health Policy in the Supreme Court and a New Conservative Majority

Within 8 days of the death of Ruth Bader Ginsburg—a pioneer of women’s rights and a liberal icon—President Trump nominated Judge Amy Coney Barrett to fill her seat. Her elevation to the Supreme Court will have profound consequences for health care and policy.

Justice Barrett opposed the Supreme Court’s 2012 decision upholding the Affordable Care Act (ACA). In California v Texas, to be argued on November 10, the Court will decide whether legislation zeroing-out the ACA’s “shared responsibility” tax penalty renders the individual mandate unconstitutional and if so, whether the entire law must be invalidated. If the Court strikes down the law, insurance safeguards will be eliminated, including protection against preexisting condition exclusions. Invalidating the ACA could cause 20 million people to lose subsidized coverage, with the number of uninsured increasing to 50 million people. With the coronavirus disease 2019 (COVID-19) pandemic and rising unemployment, the consequences could not be greater.

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