With the U.S. Supreme Court now having rejected three legal challenges to the Affordable Care Act (ACA), former President Barack Obama’s signature health care law is likely to remain codified in statute forever, one of Annapolis’ most well-known health care lobbyists said Friday.

The high court rejected the most recent challenge to the ACA on Thursday. It stemmed from a Texas lawsuit that argued that because the Trump administration’s 2017 tax reform bill eliminated penalties associated with non-compliance with the ACA’s individual mandate that therefore the rest of the law could not stand. While the court did not answer that question directly in its decision it nevertheless dismissed the suit on its merits.

The 7-2 decision by the conservative-majority court saw justices who previously ruled against the ACA, such as Clarence Thomas, vote in line with more liberal jurists such as Justice Stephen Breyer.

“It is here to stay. It is as ingrained in America as Medicare and Medicaid and Social Security. And pretty soon, if not now, it will be the third-rail killer to attack the ACA-just like it would be to attack Medicare,” Maryland Citizens’ Health Initiative President Vincent DeMarco told MarylandReporter.com.

DeMarco added: “It will be political suicide for people to attack the ACA now. It is just part of our system.”

DeMarco noted that even though Maryland already has a law in place that prohibits insurance companies from denying coverage to people with pre-existing health conditions-that had the court invalidated the ACA Maryland nevertheless would have lost a lot of money in federal subsidies.

“That would have been a finger in a dike because we would have lost $2 billion and could not have overcome that.”

As for future challenges to the ACA, they are unlikely to gain much traction, DeMarco said.

“It would be ridiculous. Somebody may file a lawsuit. But I suspect that they would be laughed out of court. It would be like somebody going to court to challenge Medicare.”

Del. Brian Chisholm, R, Anne Arundel, who sits on the Health and Government Operations Committee, also said the ACA is likely to remain a permanent part of U.S. law.

“Portions of it are definitely going to be here to stay forever. I do not think that there is the political will to overturn everything until either the quality of health coverage diminishes so much that it forces a change, or that costs go through the roof.”

Problems associated with the ACA often include high deductibles, and that alone prevents many people from visiting primary care providers, Chisholm said.

“People are avoiding seeing their primary care doctors because the deductibles are so high on some of these policies….That is my main concern with it… But I think it is probably here to stay.”

Richard Vatz, a professor of political persuasion at Towson University, said politics may have played a role in the court’s decision to uphold the ACA.

“Public opinion should not influence Court decisions, but there has long been a suspicion and soft evidence that it does. In addition, we are probably seeing the implicit influence that threats to pack the Supreme Court have on Court votes, just as FDR’s threats 9 decades ago affected the Court then.”

Vatz said the third juridical affirmation of Obamacare also probably means it is here to stay. “What to watch now is what Democrats do to expand it,” he said

The previous challenges to the ACA were heard by the court in 2012 and 2015.

Legislative efforts to repeal the ACA have largely failed to gain traction since the summer of 2017 when then-Sen. John McCain cast the decisive vote against a measure that would have gutted the law. About a year after casting that historic 2 a.m. vote the Arizona Republican succumbed to brain cancer.

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