The stage is all set for a renewed legal battle against the Affordable Care Act (ACA). On November 10th, a week after the presidential elections, the Supreme court will hear arguments as to whether the ACA should remain the law or be stricken down. This is as per the Supreme court's argument calendar. However, the final ruling is still not expected until the spring of 2021.

The heart of the matter is whether the ACA can stand without the tax mandate for individuals to have health insurance. In 2017, Congress enacted the Tax Cuts and Jobs Act (TCJA) that reduced the tax penalty for not obtaining health insurance to zero. This change became effective starting in 2019 and effectively eliminated the individual health insurance mandate under the ACA. The lawsuit challenging the law was originally brought by a group of 20 states and two individuals in early 2018. The states argued that the individual mandate was essential to the rest of the ACA, and the entire ACA was therefore invalid after the TCJA came into force. This argument relies on the Supreme Court's reasoning in the 2012 case that upheld the ACA, which found at the time that the law was an appropriate use of Congress's power to tax.