DemDaily: The Status of Your Healthcare

December 17, 2018

On Friday the security of American's healthcare took a significant setback with a ruling by a Texas federal judge that the Affordable Care Act (ACA) was unconstitutional.

Image: CNN

Although the decision does not immediately affect healthcare coverage under the act, popularly known as "Obamacare," the decision sets up yet another legal battle under the Trump administration that is ultimately expected to go to the Supreme Court.

Texas et al v. United States of America et al
In February, 2018, Texas and nineteen other Republican state attorneys general and governors, as well as two individuals, filed a civil suit in the United States District Court for the Northern District of Texas.

Their argument was that with the passage of the Republican's Tax Cuts and Jobs Act of 2017, which eliminated the individual mandate for not having health insurance, was no longer constitutional.

Judge Reed O'Connor, a well-known conservative appointed by George W. Bush in 2007, agreed.

"Individual Mandate can no longer be fairly read as an exercise of Congress' Tax Power and is still impermissible under the Interstate Commerce Clause - meaning the Individual Mandate is unconstitutional."  - - Texas Federal District Judge Reed O'Connor


Pic: Scott Olson/Getty

The mandate, which formed the basis of the ACA and required most Americans to have health insurance by 2014 or face a tax penalty, was the legal underpinning for the Supreme Court's landmark decision in National Federation of Independent Business v. Sebelius.

The 2012 ruling upheld Congress' power to enact most provisions of ACA, and the Health Care and Education Reconciliation Act (HCERA).

While O'Connor's decision did not immediately invalidate Obamacare, it threatens to wipe away healthcare protections for millions of Americans currently covered under the law -- if upheld on appeal.

The State of California, which led a coalition of 16 states and the District of Columbia in defending preservation of the law, has announced it will appeal the ruling.

Friday's "ruling is an assault on 133 million Americans with preexisting conditions, on the 20 million Americans who rely on the ACA's consumer protections for healthcare, on America's faithful progress toward affordable healthcare for all Americans." -- California Attorney General Xavier Becerra

The Impact
Should the Texas decision be upheld under appeal, guaranteed health benefits currently in place under Obamacare and the expansion of Medicaid would disappear, causing the cost of insurance to skyrocket.

That includes coverage of pre-existing conditions, which was a central focus of the 2018 elections, and an issue that helped Democrats regain control of the US House of Representatives.

Congresswoman Nancy Pelosi (CA), presumed to be the next Speaker of the House, lambasted the ruling and vowed that the Democratic-controlled House will intervene after they are sworn in as the majority in January.

Insurers would no longer be required to offer
Essential Health Benefits, including:
Pre-Existing Conditions Preventive Care and Rehabilitation Care
Emergency Services Pediatric Care
Hospitalization Caps on Out-of-Pocket Costs
Maternity and Newborn Care No Annual or Lifetime Limits on Coverage
Mental Health and Substance Abuse Prohibition on Charging More for Age, Gender or Profession
Prescription Drugs and Laboratory Services Young Adults Allowed to Remain on Parents' Insurance Policies until Age 26
"The Affordable Care act really redesigned, in a positive way, the medicare program and how we pay for care for the elderly and people over 65 years old.  This would rip out the infrastructure, the essential highway of how we deliver healthcare and that is going to be the chaos."  -- Dr. Kavita Petel, Johns Hopkins Medical Center and an architect of the ACA (MSNBC)
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Kimberly Scott

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Resources: CNN, NPR, New York Times, NBC News

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