The Supreme Court ruled today to keep the Affordable Care Act in place, meaning the law will remain intact and millions of Americans will still have health care coverage.
Here are key things to know about the law and its impact:
- What is the Affordable Care Act? The Affordable Care Act, enacted in 2010, provides Americans with essential health insurance coverage. Also known as Obamacare, it makes health insurance affordable and available to more people. One of the law's most popular provisions is its strong protections for those with pre-existing conditions, including barring insurers from denying coverage or charging higher premiums based on people's health histories. Nearly 54 million Americans – or 27% of non-elderly adults – have pre-existing conditions that would make them uninsurable in the individual market prior to the law, according to the Kaiser Family Foundation.
- Who does the law affect? Earlier this month, the administration announced that 31 million people have health coverage through the Affordable Care Act, including 11.3 million who had enrolled in Obamacare plans prior to the special enrollment period and 14.8 million who qualified for Medicaid expansion, which broadened the program to more low-income adults.
- The pandemic's impact: Over the past year, as the coronavirus pandemic and resulting economic downturn have gripped the nation, the Affordable Care Act has served as a safety net for Americans who've lost their jobs — and their health insurance along with it — and for the uninsured seeking coverage. Enrollment in both the Affordable Care Act exchanges and Medicaid have risen since the outbreak began in March 2020.
- GOP challenges: Originally, Americans were charged a monetary penalty if they did not sign up for coverage. In 2017, amendments to the Affordable Care Act removed the penalty by setting the amount to $0. This contradicted a 2012 case which held that the law’s individual coverage mandate was valid under Congress’ taxing power. Therefore, many Republicans argued that since the mandate was no longer tied to a specific tax penalty, the entire law should fall.
- What the Biden administration has done: Since taking office, President Biden has moved to strengthen the Affordable Care Act and embed it even more deeply in the nation's health insurance system, including swiftly moving to overturn many of former President Trump's efforts to chip away at the law. Biden had already reopened enrollment in the federal Obamacare exchange and beefed up marketing, outreach and assistance in signing up for policies. Increasing the number of insured Americans by strengthening the Affordable Care Act was at the heart of Biden's health care campaign promises. And his administration is reversing Trump administration approvals of work requirements in Medicaid, which threatened to strip coverage from many people who gained it through Obamacare's expansion of the program.
CNN's Alyssa Kraus contributed reporting to this post.