Word From Washington: December 14, 2018 Ruling in TX V. Azar, Update #2

Last Friday evening, we learned that a federal judge had ruled in the case of Texas v. Azar that the Affordable Care Act is unconstitutional in its entirety. This news has alarmed many. HFA staff want to update you on what we know at this point.
First and foremost, please be aware that this ruling does not affect your insurance coverage for now. The judge did not tell the government to stop enforcing the ACA, and in fact the Trump Administration Services tweeted on Friday night that “The recent federal court decision is still moving through the courts, and the exchanges are still open for business and we will continue with open enrollment. There is no impact to current coverage or coverage in a 2019 plan.”
In sum, the consumer protections of the ACA remain the law of the land, as does the ACA’s Medicaid expansion. Individuals who live in the seven states where open enrollment is ongoing (CA, CO, CT, MA, MN, NY, RI + DC) may and should sign up for 2019 coverage if they still need to do so!
What is the concern, then, over the long run? The court’s ruling, if fully implemented, would dismantle the ACA in its entirety. The ACA’s protections for people with pre-existing conditions would evaporate: health plans would once again be free to deny coverage, or charge much higher premiums, based on applicants’ health status. Tax credits that help people buy insurance on the individual market would disappear, as would the requirement that health plans cover essential health benefits.
The ruling’s impact would also be felt far beyond the individual insurance market and the ACA Exchanges. Large employers would no longer have to offer insurance to their employees. Health plans could re-introduce annual and lifetime caps on benefits; would not have to limit patients’ yearly out-of-pocket costs; would not have to allow parents to keep their children covered up to age 26; and more. The ACA’s Medicaid expansion would disappear, eliminating coverage for many millions of people in 33+ states. Provisions that save money for Medicare enrollees would also expire.
Again, these are the consequences that could ensue if the court’s ruling were fully implemented as written. But the ACA’s consumer protections and other provisions remain in effect for the time being.
What will happen next? The parties defending the ACA in court – California and 16 other states – have promised to appeal the anti-ACA ruling to the US Fifth Circuit Court of Appeals and, if necessary, on to the US Supreme Court.
Many legal experts (both pro- and anti-ACA) are highly critical of the court ruling and think it should and will be overturned. But earlier litigation over the ACA has sometimes produced unexpected results, so we will continue to watch this matter closely.
HFA has joined with 36 other patient groups to issue a statement regarding the court ruling. We will continue to update you about the ongoing litigation, and will continue our efforts to advocate for the affordable, quality coverage that we need, in all the forums available to us, at the state and federal levels. Please stay tuned – and thank you for your interest and engagement.