Few issues received as much attention in the run up to the 2020 presidential election as the Affordable Care Act, widely referred to as Obamacare. As is well known to those who followed the campaign, in Washington, D.C. on Tuesday, the U.S. Supreme Court heard arguments on the legality of Obamacare.

At a Monday news conference on the eve of arguments, California Attorney General Xavier Becerra spoke about the importance of the case and California’s critical role in defending the legality of Obamacare.

The high court hears the matter after the U.S. Court of Appeals for the 5th Circuit affirmed a lower court ruling that the act’s individual mandate was unconstitutional after Congress reduced the penalty amount to zero. The 5th Circuit did not decide whether invalidating the mandate affected the other provisions of the act and sent the case back to the trial court to explore that issue.

California leads a coalition of 20 states and the District of Columbia, and has taken on the role of defending the act because the Trump administration has sided with a group of Republican states in arguing that the individual mandate is not only unconstitutional, but because that provision is central to the act as a whole, the entire 900-page statute should fall as well.

The California-led group argues that the plaintiffs do not have standing to sue, that the individual mandate is constitutional, and, even if it were found to be infirm, the rest of the act can be “severed” from the unconstitutional part and continue in full force and effect.

Pre-existing conditions in spotlight

At the Monday news conference, Becerra emphasized the importance of the act to the many California residents who rely on it for health coverage. He also emphasized that the provision of the act that prevents insurance companies from denying insurance to those with pre-existing conditions would fall if the entire act were struck, making the outcome of the case critical to people regardless of whether their insurance was obtained under the act.

Becerra introduced Dr. Jamila Perritt, president and CEO of Physicians for Reproductive Health, who pointed out that pre-existing conditions are not limited to rare genetic conditions, but include relatively common medical conditions such as high blood pressure or having had a prior cesarean section.

According to Becerra, as many as 133 million people (including 17 million children) “rely on the ACA to keep their healthcare affordable and to protect them from being denied coverage by insurers.”

He could not predict when the Supreme Court would decide the matter, but expected it would be before the end of the court’s current term in June. Meeting remotely on Tuesday for the first time since last week’s General Election, the justices indeed appeared ready to stand behind the ACA if not the individual mandate.

The high court previously upheld Obamacare in a 5-4 decision with Justice Ruth Bader Ginsburg voting in the majority. Following Ginsburg’s death in September, the president appointed, and the Senate confirmed, Amy Coney Barrett, to the high court.

Becerra was optimistic that California would be successful. He told the audience at the news conference, “you don’t need to keep your fingers crossed, just keep your hopes high.”

Joe Dworetzky is a second career journalist. He practiced law in Philadelphia for more than 35 years, representing private and governmental clients in commercial litigation and insolvency proceedings. Joe served as City Solicitor for the City of Philadelphia under Mayor Ed Rendell and from 2009 to 2013 was one of five members of the Philadelphia School Reform Commission with responsibility for managing the city’s 250 public schools. He moved to San Francisco in 2011 and began writing fiction and pursuing a lifelong interest in editorial cartooning. Joe earned a Master’s in Journalism from Stanford University in 2020. He covers Legal Affairs and writes long form Investigative stories. His occasional cartooning can be seen in Bay Area Sketchbook. Joe encourages readers to email him story ideas and leads at joe.dworetzky@baycitynews.com.