In a radical departure from established legal doctrine, a federal judge in Texas issued a ruling against the Affordable Care Act (ACA) on December 14, claiming that the entire law must fall. At the center of the lawsuit, brought by a coalition of Republican-led states, was the ACA’s individual mandate and penalty for failure to be insured. Congress repealed this penalty in last year’s tax bill. As a result, the lawsuit claimed the ACA was invalid. Unfortunately, the district court in Texas agreed with this flawed analysis, although legal scholars have denounced it across the ideological spectrum.
The ruling amounts to judicial sabotage of the ACA. While the decision will likely be appealed, it represents a blow to the rule of law, and, potentially, to our health care system. The decision could cause an additional 17 million Americans to lose health coverage in 2019 alone, while jeopardizing it for millions more, including an estimated 133 million Americans under 65 with pre-existing conditions who rely on the ACA’s coverage and consumer protections. Older adults would be disproportionately impacted, as the likelihood of having a pre-existing condition increases with age: up to 84% of those ages 55 to 64 — 31 million individuals — have a pre-existing condition for which they could be denied coverage or charged an unaffordable rate absent the ACA’s important protections.
The ACA is the most important health law since Medicare and Medicaid. It gives people with pre-existing conditions access to quality and often life-saving coverage. Because of the law, millions of people now have access to essential benefits such as prescription drugs, preventive services, emergency services, and hospitalization. The ACA also allows parents’ plans to cover children up to age 26, prohibits caps on coverage, prevents insurers from imposing an “age tax” on older adults, makes many preventive services free to patients, and closes the Medicare Part D “Donut Hole” gap in coverage. By reducing Medicare spending, it extends the life of Medicare’s trust fund. All of these benefits of the ACA are in jeopardy if this decision is upheld.
It is important to remember that the ACA is still the law of the land. The misguided Texas decision is expected to be appealed to the Fifth Circuit and to the Supreme Court. As part of its continuing pattern of sabotage, the Administration chose not to defend the ACA in this lawsuit. However, several states have joined to support the law, and the incoming House of Representatives leadership has signaled its intent to intervene on the side of the ACA.
The courts must not be used to sabotage access to health care. We call on the Administration to stop sabotaging the Affordable Care Act and to defend the law. As was apparent on Election Day, this is also the will of the majority of Americans.
This article was originally released as a joint statement from the Medicare Rights Center and the Center for Medicare Advocacy. The statement can be found here.
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