The court's one-sentence order only said the justices would not take up the case in an unusually rapid order, and it did not rule out full review of the case at a later date.

In deciding to immediately stay out of the fray, the justices sided with the Trump administration and group of red states leading the challenge to Obamacare. They opposed an immediate Supreme Court review of the case, arguing that there was no "emergency," even as Democrats argued that prolonging uncertainty around Obamacare harms the millions of people who rely on the law for insurance. It could take years for lower courts to resolve the lawsuit.

A spokesperson for California Attorney General Xavier Becerra, who's leading the defense of the health care law, said Democrats are "cautiously optimistic" the Supreme Court will still agree to review the case by next term, which starts in October.

The outcome means Trump will face less pressure to articulate an Obamacare replacement plan during the campaign. Republicans failed to agree on an Obamacare replacement when they had complete control of the federal government in the first two years of Trump's presidency, and they haven’t come up with a new plan since then. A health care proposal developed by Trump's Medicare chief Seema Verma was nixed last summer over her colleagues' concerns it would have actually strengthened Obamacare rather than replace it.

The lawsuit's lingering threat to Obamacare exposes Trump to attacks that he is still trying to gut the law's popular protections for people with preexisting conditions. Democrats leveraged the lawsuit and voters’ worries about health coverage to secure huge gains in the 2018 midterms, retaking the House majority. Still, they worry that Republicans could dodge political consequences if Obamacare is ultimately struck down after the November election.

"Coverage for millions of Americans and protections for pre-existing conditions are on the ballot," former Vice President Joe Biden tweeted Tuesday in reaction to the Supreme Court's announcement. "We have to protect the progress we've made and show up to the polls to defend the Affordable Care Act."

Make no mistake, Obamacare is on the ballot this November. Coverage for millions of Americans and protections for pre-existing conditions are on the ballot.



We have to protect the progress we've made and show up to the polls to defend the Affordable Care Act. https://t.co/tWaiPrVAKr — Joe Biden (Text Join to 30330) (@JoeBiden) January 21, 2020

Trump, who has appeared sensitive to Democratic attacks on his efforts to wipe out Obamacare, last week falsely claimed on Twitter he “saved Pre-Existing Conditions in your Healthcare,” despite his support for a lawsuit that would eliminate those protections. Trump also lashed out at Health and Human Services Secretary Alex Azar last Thursday over polling that shows Americans trust Democrats more on health care.

White House spokesperson Judd Deere on Tuesday said Trump is working to improve health care, "including creating a system that protects the vulnerable and those with pre-existing conditions." Earlier in the day, Azar during a radio interview downplayed the need for Trump to produce an Obamacare replacement plan unless the Supreme Court throws out all or part of the law or "until there's a Congress that would work with the president."

“Frankly it’s not a material thing right now,” Azar told conservative radio host Kevin Wall.

Republicans held both chambers of Congress during Trump’s first two years in office and failed to agree on on a replacement.

The Supreme Court doesn't disclose how each justice votes on accepting individual cases, so it's unclear who refused Democrats' request to fast-track the case. Five justices are needed to grant expedited review. Four votes are needed to take a case on a regular schedule.

The lawsuit was considered a long shot when it was introduced nearly two years ago, but it’s since emerged as a major threat to Obamacare.

Those challenging the law argue that Obamacare was invalidated when Congress in late 2017 removed the law's tax penalty for not having health insurance but left the rest of the coverage requirement on the books. They contend that move rendered Obamacare unconstitutional, since the Supreme Court previously upheld the individual mandate solely as a legitimate exercise of congressional taxing power.

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A three judge panel of the 5th Circuit Court of Appeals last month refused to decide whether any part of the law could stand after Congress zeroed out the tax penalty. They instead sent the case back to the Texas federal judge to decide what parts of the law could remain in place.

Leading associations of health insurers, hospitals and patient advocates had urged the Supreme Court to quickly resolve Obamacare’s fate, citing uncertainty stemming from a lawsuit with the potential to wreak havoc on a health care system that’s adapted to the decade-old law.

Insurers expect, however, that the court’s refusal to immediately tackle the lawsuit likely ensures Obamacare’s next enrollment season will take place as scheduled in the fall. Enrollment on HealthCare.gov dipped just slightly in the latest sign-up season that ended last month, and the law’s insurance marketplaces have largely stabilized since Republican efforts to repeal Obamacare failed in 2017.

