HAP, Hospitals Lament Texas Court Ruling that ACA Is Unconstitutional, But Emphasize that Coverage Remains Unaffected > Hospital Association of Pennsylvania


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HAP, Hospitals Lament Texas Court Ruling that ACA Is Unconstitutional, But Emphasize that Coverage Remains Unaffected

December 17, 2018

Hospitals and health systems in Pennsylvania and nationwide are extremely disappointed with the recent federal district court ruling declaring the Affordable Care Act (ACA) unconstitutional. The ruling puts at risk comprehensive health coverage for millions of Pennsylvanians, including those with pre-existing conditions and those who rely on the marketplace and Medicaid expansion and for their coverage.

Governor Tom Wolf, Insurance Commissioner Jessica Altman, and Secretary of Human Services Teresa Miller have condemned the court decision and vowed to enforce the law. They reminded Pennsylvanians that plans selected during the recently ended open enrollment period will be unchanged by the ruling and that all ACA provisions, including coverage protections, remain the law of the land while court proceedings play out. Key ACA protections include coverage for:

  • Pre-existing conditions
  • Mental health and substance use disorders
  • Prescription drugs
  • Preventive care at no cost to beneficiaries

Texas federal district court judge Reed O’Connor ruled that the entire ACA is unconstitutional because Congress zeroed out the penalty tied to the individual mandate, which provides that citizens must have health insurance.  The ruling reasoned that the individual mandate is “essential” to the ACA and inseverable. Thus, the entire law is invalid; however, the ruling did not enjoin the law so it remains in effect in all 50 states and the District of Columbia. 
The Trump Administration had sided with the Texas-led state coalition in arguing that key parts of the ACA should be invalidated, including crucial consumer protections. In an amicus brief filed earlier this year, the American Hospital Association (AHA) and others urged the court not to accept this severability argument. HAP, the AHA, and others are urging a stay in this decision until a higher court can review it and are anticipating an immediate appeal of the decision. 
An appeal would go to the Fifth Circuit Court of Appeals, which is considered one of the more conservative appeals courts. If the Fifth Circuit agrees with this latest ruling, then the U.S. Supreme Court would have to decide if it wants to hear the case.

Legal scholars have speculated that Supreme Court precedent on severability does not align with the federal district court decision. However, the precedent has not been tested with the new makeup of the Supreme Court.
HAP will continue to advocate for affordable, comprehensive coverage for as many Pennsylvanians as possible, and for protection of access to care for all Pennsylvanians. Leading into the 116th Congress, HAP will urge the Pennsylvania Congressional delegation to support efforts to preserve and strengthen coverage gains resulting from the ACA, and make it an even more effective means of increasing access to health coverage. 
For more information, please contact Laura Stevens Kent, HAP’s vice president, federal legislative advocacy.

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