Plain-English summary
Court upholds most of ACA, rejects whole-law strike after mandate ruled unconstitutional
In Texas v. California (2021), the Supreme Court agreed the individual mandate — stripped of its tax penalty — could not be enforced as a tax but held that the rest of the Affordable Care Act (ACA) should remain in place. The Court reversed a lower court that had invalidated the entire law and sent the case back for further proceedings.
Why this matters
The ACA provides health coverage protections for millions, including rules preventing health insurers from denying coverage for preexisting conditions and allowing young adults to stay on parents' plans. If the Court had struck down the entire law, those protections and coverage systems could have collapsed. This decision preserved the broader law while leaving open questions about how to address the invalid mandate.
Who may feel it
- People with preexisting medical conditions
- Individuals who buy insurance on ACA marketplaces
- Medicaid and Medicare enrollees affected by ACA-related rules
- States that expanded Medicaid or rely on ACA programs
- Insurers and health-care providers
Key questions
- Was the individual mandate constitutional after Congress set the penalty to zero?
- If the mandate is unconstitutional, is it "severable" from the rest of the ACA — meaning must the whole law be invalidated or can most of it remain?