On Tuesday, November 10, 2020, the U.S. Supreme Court heard oral arguments on the third case challenging the constitutionality of the ACA.  The case brought by a number of Republican State Attorney Generals arose because Congress reduced the penalty attached to the individual mandate to zero. 

On Friday, July 31, 2020, the U.S. Court of Appeals for the Fifth Circuit overturned a lower court decision and upheld the provider fee that states are required to pay under Section 9010 of the ACA, on behalf of MCOs, in order for the states to receive federal reimbursement for payments to the MCOs.