Florida leads nation in ACA sign-ups as Supreme Court hears case

ORLANDO, Fla. — Since 2014, the number of Floridians covered by the Affordable Care Act has more than doubled. Enrollment in the federal health care exchanges is currently open, but in 2020 more than 1.9 million Floridians were covered through the exchanges — the most in the country.

Now, one week after the presidential election, the Supreme Court of the United States is taking up a challenge to the ACA.

It’s a challenge that could change the law but leave it intact or strike it down in its entirety.

“You have to parse out what this case is really about and it really comes in three parts,” said federal judiciary expert Anthony Marcum of the R-Street Institute.

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Marcum said the case comes down to: standing, constitutionality of the insurance mandate, and severability of the mandate from the law.

On the issue of standing, Marcum said the court will need to decide if the individuals in the case are in a legal position to bring the lawsuit.

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If there is standing, then the case moves on to the mandate itself. In 2017, Republicans in Congress, as part of the TCJA, zeroed out the penalty for not having health insurance. 

Following the change, Texas as well as 18 other states, including Florida, signed up to a lawsuit challenging the constitutionality of the law saying that since in an earlier Supreme Court decision the court had held that the ACA was a tax, zeroing out the tax nullifies the law.

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But even without the tax there is still a question as to whether the court could cut the tax off from the law, while keeping the rest of the ACA in place, including the health care markets and coverage for preexisting conditions.

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“Chief Justice Roberts and Justice Kavanaugh were very critical about the idea that you could not sever the individual mandate from the rest of the law,” notes Marcum, referring to Tuesday’s arguments. “Chief Justice Roberts asked, noting that if Congress wanted to end the Affordable Care Act they could have ended the Affordable Care Act, and Justice Kavanaugh mentioned that president in his view says pretty clearly that you can sever this part of the law that might be unconstitutional from the rest of the law.”

Cox Media Group