Attorney General James Helps Secure Survival of Affordable Care Act with Supreme Court Victory

State AGs Block Effort to Strike Down ACA and Many Health Care Protections,

Including Coverage for 133 Million Americans with Pre-Existing Conditions


NEW YORK – New York Attorney General Letitia James and a coalition that included 20 states and the District of Columbia scored a major victory today after the United States Supreme Court rejected a challenge to strike down the Patient Protection and Affordable Care Act (ACA) in the case California v. Texas. The coalition defended the ACA against a lawsuit brought by a Texas-led state coalition that sought to dismantle the health care reform law, which has provided new coverage to at least 20 million Americans, coverage for pre-existing conditions for more than 133 million Americans, the ability for young adults to stay on a parent’s health plan, and more. The Supreme Court overturned the decision by a lower court, holding that the Texas-led coalition never established the standing needed to bring this lawsuit in the first place.


“For more than a decade, the Affordable Care Act has been the law of the land, providing health coverage and a multitude of protections to tens of millions of Americans across the nation, and today’s decision solidifies those protections for generations to come,” said Attorney General James. “While Republicans have repeatedly tried to take us backwards in time and strip health coverage away from millions, we have now beaten those efforts over and over again and, specifically, three times at the Supreme Court. The ACA is here to stay, and millions of Americans nationwide can now breathe a sigh of relief. Young people, seniors, women, those with disabilities, those with pre-existing conditions, low-income Americans, and millions more will continue to receive the coverage they have come to rely on since the law’s passage in 2010. While we celebrate today’s decision our coalition will remain vigilant against further attempts to deprive millions of Americans access to quality, affordable health care and will be ready to take any further action necessary to protect Americans’ right to health coverage.”


Among other things, at risk with today’s decision was:

  • Health care for the more than 20 million Americans who are now able to afford health insurance either through Medicaid expansion or thanks to tax credits and employer-sponsored plans through health care exchanges.

  • Guaranteed coverage for the more than 133 million Americans who have a pre-existing health condition, including 17 million kids, that benefit from the law’s protections against discrimination and higher costs based on health status.

  • Health care for young adults under the age of 26 covered by a parent’s plan.

  • Health care for families of children with chronic health conditions who are currently protected from lifetime insurance limits.

  • Funding for our nation’s public health system, which includes investments in local and state public health systems that have helped during the COVID-19 pandemic; FDA biosimilars, which power drug costs; and more, including Medicare payment reforms, Indian health services, and work to fight the opioid epidemic.

The lawsuit — originally filed by a Texas-led coalition and later supported by the Trump Administration — argued that Congress rendered the ACA’s individual mandate, or minimum coverage provision, unconstitutional when it reduced the penalty for forgoing coverage to $0. The lawsuit further argued that the rest of the ACA should be held as invalid as a result of that change. But the court, today, found that the Texas-led coalition never established the standing to bring the case in the first place and rejected all arguments made.


Attorney General James and a coalition of attorneys general first defended the ACA in court in January 2019.


In addition to New York, the coalition that brought the case before the Supreme Court included the attorneys general of California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Massachusetts, Michigan, Minnesota (by and through its Department of Commerce), Nevada, New Jersey, North Carolina, Oregon, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia, as well as the governor of Kentucky.


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