WASHINGTON, D.C. — A Republican challenge to the Affordable Care Act (ACA), or Obamacare, failed in the U.S. Supreme Court on Thursday.

This was the third such a challenge to the law shot down by the highest court in the country since the law’s enactment in 2010. The latest decision by the Supreme Court will keep intact the law, which brings health insurance access to millions of working class Americans, and its protections for people with preexisting health conditions.

The justices ruled 7-2 that Republicans lacked standing to sue. The case came to the Supreme Court after 18 Republican states, led by Texas, had brought a legal challenge in 2018 aimed at striking down the ACA. The case focused on the tax penalty meant to encourage the purchase of health insurance by most Americans, known as the individual mandate. They argued that former President Trump’s 2017 tax cut, which zeroed out the penalty, made that provision unconstitutional.

A federal judge in Texas had ruled that Obamacare as structured following the 2017 change violated the Constitution and was entirely invalid.

In its latest ruling, however, the Supreme Court questioned whether the states had standing to challenge the law at all, instead of deciding on the broader claims by Republicans.

Justice Stephen Breyer wrote the majority opinion. Joining him were fellow liberal justices Elena Kagan and Sonia Sotomayor, and four conservatives, Chief Justice John Roberts and Justices Clarence Thomas and Trump appointees Brett Kavanaugh and Amy Coney Barrett.

Justices Neil Gorsuch, also a Trump appointee, and Samuel Alito voted in dissent.

Breyer wrote that none of the challengers could show a legal injury from the individual mandate, since Trump’s tax cut had wiped out the financial penalty.

“Unsurprisingly, the states have not demonstrated that an unenforceable mandate will cause their residents to enroll in valuable benefits programs that they would otherwise forgo,” Breyer wrote.

Alito wrote that the individual mandate was “clearly unconstitutional” and called the court’s ruling “judicial inventiveness.”

The Biden administration recently announced that a record 31 million people were covered under Obamacare, as reported by The Hill. President Biden called the decision, “a big win for the American people.”

Up to 20 million Americans could have lost their medical insurance if Obamacare had been struck down by the court. Insurers could have once again refused to cover people with pre-existing medical conditions. 133 million Americans, including 17 million children, have pre-existing health conditions and benefit from the law’s guaranteed coverage and protection against discrimination and higher costs based on their health status.

The ACA also covers families of children with chronic health conditions who are protected from lifetime insurance limits, and anyone under the age of 26 who can remain on their parent’s health insurance plan.

“The ACA continues to win time and time again because Americans continue to make their voices heard about much-needed access to healthcare,” said U.S. Rep. Debbie Dingell (D-Dearborn). “With over 31 million Americans relying on the ACA for health insurance and ACA premiums decreasing over the last three years, we have a responsibility to protect and improve our nation’s healthcare system, including expanding Medicaid. It’s time to fix what we all know doesn’t work in the ACA and give people the peace of mind that the provisions that do work – the provisions they depend upon – will be protected.”

Michigan Attorney General Dana Nessel commended the California Department of Justice for leading a nationwide bipartisan coalition in defense of the ACA.

“I am proud to be among the 20 attorneys general who fought to defend the Affordable Care Act and applaud this ruling alongside the millions of people who have worried about their benefits being stripped away,” Nessel said. “This decision from the United States Supreme Court rejecting the challenge to the ACA ensures the Act remains in place to protect the health and lives of millions of Americans by providing coverage and access to comprehensive treatments.

“In Michigan, that includes more than 1.7 million people with pre-existing conditions, more than 900,000 covered through Medicaid expansion, and more than 70,000 young adults on their parents’ coverage.”