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Texas Judge Strikes Down Affordable Care Act

Posted Monday, December 17, 2018 by Pivotal Law Group

A federal judge in Texas has ruled the Affordable Care Act (a/k/a “Obamacare”) can no longer be enforced. The judge determined the Act cannot function without its individual mandate requiring virtually all Americans to carry minimum health coverage. Congress repealed the ACA’s individual mandate at the end of 2017.

If the ruling becomes the law of the land, it will have serious implications for health insurance coverage. Among other things, the ruling eliminates the ACA’s minimum coverage requirements including guaranteed coverage for people with pre-existing health conditions, emergency medical treatment, maternity and newborn care, mental health and substance abuse treatment, prescription drugs and pediatric care.

The ruling has the potential to eliminate health coverage for about 17 million Americans — including millions who gained coverage through the ACA’s expansion of Medicaid. Policyholders with pre-existing conditions could see significant premium increases once the ACA’s prohibition against increased charges for pre-existing conditions become void.

For the time being, the ruling has little practical impact for insureds. The federal Centers for Medicare and Medicaid Services emphasized “There will be no impact to enrollees’ current coverage or their coverage in a 2019 plan”. For now, the biggest concern is that the ruling will confuse insureds into failing to purchase coverage during open enrollment, which CMS states will proceed normally.

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