The Constitution, Coronavirus, and Care: How the ACA Trilogy and the COVID-19 Pandemic Created New Bases for Medicare-for-All

American healthcare is expensive. Despite decades of attempts to make care affordable, many people in the United States remain uninsured or otherwise experience high out-of-pocket costs. H.R. 1976, the Medicare for All Act of 2021, provides a solution where the federal government directly covers medical care for all residents. Medicare for All is popular, sensible, and humane, especially in the wake of the COVID-19 pandemic. But if the Act were to pass, it would face a similar fate to that of the Affordable Care Act just over a decade ago—endless litigation, some of which might land before the Supreme Court. 

This Note assesses Medicare for All’s future in light of the Supreme Court’s Affordable Care Act holdings and the COVID-19 pandemic. Part I summarizes the history of healthcare reform, the status of healthcare in the United States, and the contents of the Affordable Care Act and H.R. 1976. Part II analyzes how the Medicare for All Act might be evaluated based on the Supreme Court’s relevant holdings in the Affordable Care Act cases. Finally, Part III assesses how the COVID-19 pandemic heightened the need for Medicare for All through the lens of the health justice framework. This Note concludes that Medicare for All makes sense both legally and ethically, though advocates for the proposal will need to be prepared for challenges should the law come to pass.