Victory! Supreme Court Upholds Affordable Care Act Once Again

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“There is no way to overstate how significant of an impact the ACA has had on the health of marginalized communities… For so many, these reforms were revolutionary.”
June 17, 2021

Today, the United States Supreme Court, in a 7-2 decision, rejected a challenge to the Affordable Care Act (ACA). In its decision, the court held that neither the individual plaintiffs nor the states had standing to challenge the ACA’s individual mandate provision after its accompanying tax penalty had been zeroed out. Lambda Legal had urged the Court in an amicus brief to uphold the law, citing how the ACA had expanded access to health care for vulnerable communities such as people living with HIV, LGBTQ people, those with low incomes, and communities of color.

“COVID-19 has shone a light on the critical importance of health care access and the horrifying disparities in health care among vulnerable communities,” said Lambda Legal Senior Attorney and Health Care Strategist Omar Gonzalez-Pagan. “For more than eleven years, the Affordable Care Act has made it possible for more than 20 million people to see a doctor or health care provider when needed, and who without the ACA would otherwise be left to fend for themselves. Today, the Court ensured that the ACA will continue to be a critical lifeline for the people most in need by rejecting yet another frivolous challenge.”

This was the third challenge to the ACA since its enactment in 2010 to come before the U.S. Supreme Court. The Justices ruled that the plaintiffs did not have standing to challenge the individual mandate after its accompanying tax penalty had been zeroed out in 2017, thereby upholding, once again, the entire law and ensuring that provisions such as the expansion of Medicaid, antidiscrimination protections for LGBTQ people, and those who have pre-existing conditions such as HIV, continue.

“There is no way to overstate how significant of an impact the ACA has had on the health of marginalized communities,” added Gonzalez-Pagan. “The ACA’s health care reforms—such as expansion of Medicaid, nondiscrimination protections under Section 1557, and protections for people with preexisting conditions—made it possible for more people to access care, including people living with HIV, those with lower incomes, and those who have faced barriers to care in the past such as LGBTQ people and people of color. For so many, these reforms were revolutionary.”

ACA reforms have helped an estimated 20 million people obtain health insurance and with it access to lifesaving medical care, including many living with HIV who were previously denied coverage because their HIV status constituted a pre-existing condition or because they simply could not afford it.

Lambda Legal filed an amicus brief on behalf of 16 nonprofit organizations that advocate for people living with HIV in support of 19 states and DC, led by California, and the U.S. House of Representatives who collectively defended the Affordable Care Act (ACA) and appealed a ruling from the Fifth Circuit Court of Appeals that invalidated the individual mandate, a key provision of the ACA, and threatened the law in its entirety. In the brief, Lambda Legal urged the Court to uphold the constitutionality of the ACA and described its role in expanding health care coverage for people living with HIV, particularly those with lower incomes or who have faced barriers to care in the past such as LGBTQ people and people of color.

The cases are California v. Texas, brought by 19 states led by California and includes New York, Illinois, Virginia, Massachusetts, Connecticut, Delaware, Hawaii, Minnesota, New Jersey, North Carolina, Oregon, Rhode Island, Vermont, Washington, Colorado, Iowa, Michigan, Nevada, the District of Columbia, and the governor of Kentucky, and Texas v. California, led by Texas on behalf of that state, Alabama, Arizona, Arkansas, Florida, Georgia, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, North Dakota, South Carolina, South Dakota, Tennessee, Utah, and West Virginia. The U.S. House of Representatives intervened in support of the states led by California and in defense of the ACA.

Signatories include AIDS United, American Academy of HIV Medicine, Black AIDS Institute, Center for Health Law and Policy Innovation, GLBTQ Legal Advocates & Defenders, Housing Works, Human Rights Campaign, Latino Commission on AIDS, National Alliance of State & Territorial AIDS Directors, National Black Justice Coalition, National Center for Transgender Equality, National Minority AIDS Council, Positive Women’s Network - USA, The AIDS Institute, and Whitman-Walker Health and the Whitman-Walker Institute.

Read the Supreme Court’s opinion here:

Read Lambda Legal’s amicus brief here:



Contact Info

Graciela González, Cell: 312-545-8140; Email: