Affordable Care Act Struck Down in Federal Court: What’s Next
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Affordable Care Act Struck Down in Federal Court: What’s Next

Author: John Falardeau/Wednesday, December 19, 2018/Categories: Practice and Payment, Policy and Advocacy

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by John Falardeau

Late last Friday evening, a Texas federal judge struck down the entire Affordable Care Act. It wasn’t long after that the California attorney general's office said California and other defendant states would challenge the ruling with an appeal in the U.S. Court of Appeals for the Fifth Circuit.  California and the others probably will focus on the various patient protections such as coverage for pre-existing conditions. Such an approach would by necessity also include the other patient protections such as Section 2706 of the Act.  What we know now is that the law will remain in place through the appeal process up to its probable hearing before the Supreme Court.

Since the ruling last Friday, it’s been reported that the most damaging fallout is simply confusion.  With Saturday, Dec. 15, the very next day, being the last day for open enrollment for the Act’s insurance marketplaces, we may see decreased enrollments due to the prior night’s ruling. However, while the immediate effects of the ruling are minimal, there could again be large confusion and misunderstanding among consumers not only in the Act’s markets, but within virtually all markets.  Individuals with pre-existing conditions may also be caught up in the media maelstrom connected with the judge’s ruling.

Should the case reach the Supreme Court and justices strike down even parts of the law, it would have implications for the entire healthcare industry.  On Monday, stock prices for many major health insurance companies tumbled upon news of the Friday night ruling.  Basically, the uncertainty now attached to a major portion of this country’s health delivery system, albeit it minimal, is certainly going to get the attention of Congress, which starts its next session in early January.

Should the case reach the Supreme Court and justices strike down even parts of the law, it would have implications for the entire healthcare industry.  On Monday, stock prices for many major health insurance companies tumbled upon news of the Friday night ruling.  Basically, the uncertainty now attached to a major portion of this country’s health delivery system, albeit it minimal, is certainly going to get the attention of Congress, which starts its next session in early January.

Leaders from both sides of the Capitol, and from both sides of the aisle, already acknowledge that if the Act is suddenly dismantled, the adverse effects suddenly thrown on patients would be more than either political party can bear to stomach.  Democrat leaders in the House of Representatives, poised to take the majority next month, have vowed to act swiftly.  Rep. Richard Neal (D-Mass.), the incoming Ways and Means chairman, said shortly after the ruling came down on Friday, that “House Democrats will do whatever it takes to make sure protections enshrined in the Affordable Care Act endure,” and that protecting pre-existing conditions will be a top priority next year.  Current House Energy and Commerce Chair Greg Walden (R-Ore.), went so far as to call the ruling “a rare opportunity for truly bipartisan healthcare reform that protects those with pre-existing conditions, increases transparency and choice, and lowers costs.”

It may be months before the Supreme Court takes up this latest ruling related to the Affordable Care Act; however, Congress appears ready to take some sort of action before the Court can intervene.  Nevertheless, given the divisive nature of the legislative branch, and the penchant for gridlock, depending on Congress to find a solution may be a bridge too far.

John Falardeau is ACA senior vice president of policy and advocacy.

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