The U.S. Supreme Court will hear the appeal of a lawsuit challenging the constitutionality of the entire Affordable Care Act (ACA) during its 2020–2021 term, which begins October 2020. While it is possible that oral arguments in California v. Texas could occur before the 2020 general election, a decision is not expected until June 2021.

The penalty for the individual mandate was eliminated by Congress as part of the Tax Cuts and Jobs Act of 2017, with the individual mandate provision taking effect in 2019. In December 2019, a federal appeals court held that without the penalty, the mandate cannot be upheld as an exercise of Congressional taxing power and is therefore unconstitutional. The question now is whether the mandate can be “severed” from the rest of the ACA or if most or all of the law must be struck down.

Regardless of who controls Congress or occupies the White House in 2021, if the court decides that all or most of the law must be overturned, there will be a rush to action. The most obvious impacts on dental practice will be if practice owners currently provide health coverage for their staff through a Health Insurance Marketplace (exchange) policy and/or if they treat patients who have dental benefits through Medicaid or an exchange plan.

AGD will monitor the court filings as the California v. Texas appeal progresses, including the many amicus curiae (friend of the court) briefs and the oral arguments themselves. AGD’s response to any change in the law will be guided by AGD Policy on Health Care Reform.