The U.S. Supreme Court ruled again in favor of Obamacare in a 7-2 decision handed down on Thursday. This is the third major challenge in the past decade that the Affordable Care Act (ACA) has faced from Republican officials.

GOP challengers have argued that former President Donald Trump‘s 2017 tax cut has made Obamacare unconstitutional by ridding it of the tax penalty, a provision that Republicans say was used to prompt Americans to purchase health insurance.

Republicans have argued that it should be invalidated by the Supreme Court because the law is no longer a tax law.

Justice Stephen Breyer ruled in support of Obamacare along with liberal Justices Sonia Sotomayor and Elena Kagan as well as the more conservatives justices, like Chief Justice John Roberts and Justices Clarence Thomas, Amy Coney Barrett and Brett Kavanaugh.

The challenges that Republicans had previously raised to Obamacare were not brought up in the decision.

“We do not reach these questions of the Act’s validity, however, for Texas and the other plaintiffs in this suit lack the standing to raise them,” Breyer wrote for the majority.

At the same time, the conservative Justices, Samuel Alito and Neil Gorsuch, wrote in dissent: “No one can fail to be impressed by the lengths to which the Court has been willing to go to defend the ACA against all threats,” wrote Alito in tandem with Gorsuch. “So a tax that does not tax is allowed to stand and support one of the biggest Government programs in our Nation’s history. Fans of judicial inventiveness will applaud once again.”

Obamacare’s defenders have also included 20 blue states and the Democratic-led House. Lower courts had ruled against Obamacare.

Supporters of Obamacare have lauded it for expanding Medicaid and making private health plans more affordable. It has also been helpful during the pandemic for those people who lost their job-based coverage. Thirty-one million people have used Obamacare so far.

Democratic lawmakers hope to add to the plan by adding to provisions to lower prescription drug costs and establish government-run public health insurance options.

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