What Was At Stake in the Supreme Court Obamacare Ruling

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That’s how much the uninsured population declined in the first 10 years of the Affordable Care Act, progress that’s more likely to stand after the Supreme Court dismissed a challenge to the health insurance legislation Thursday.

The number of non-elderly people without health insurance had dropped to 30 million as of the first half of 2020 from 48.2 million in 2010, when the federal government enacted the Affordable Care Act, according to a February report from the Department of Health & Human Services attributing the decline largely to the legislation. That translates to 11.1% of the U.S. population, down from an uninsured rate of 18.2% in 2010.

In June of 2021, the U.S. Supreme Court ruled 7-2 to dismiss the challenge to the landmark legislation, which has subsidized coverage through government-run health insurance marketplaces. A group of 18 states led by Texas alleged the law was unconstitutional after the penalty it had originally imposed on people who didn’t get health insurance was eliminated in 2019, effectively rendering the requirement to get basic health coverage moot. But the high court said the states failed to prove how the requirement for health coverage had caused harm.

The decision to uphold the law—also known as Obamacare because it was spearheaded by former President Barack Obama—was heralded by President Joe Biden, who specifically noted provisions that protect people from being denied coverage for pre-existing conditions.

“It is a victory for more than 130 million Americans with pre-existing conditions and millions more who were in immediate danger of losing their health care in the midst of a once-in-a-century pandemic,” he said in a statement issued by the White House.


A special enrollment period to sign up for coverage under the Affordable Care Act lasts through Aug. 15. Biden established it in February and said Thursday more than 1.2 million people have signed up.

Have a question, comment, or story to share? You can reach Rob at ranthes@thebalance.com.

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  1. Assistant Secretary For Planning And Evaluation. "Trends In The U.s. Uninsured Population, 2010-2020," Page One.

  2. Supreme Court Of The United States. "October Term, 2020 Supreme Court Of The United States, Syllabus, California Et Al. V. Texas Et Al," Pages 1-3.

  3. The White House. "Statement By President Joe Biden On The U.S. Supreme Court Decision Upholding The Affordable Care Act."

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