Lawmakers Taking Action in Face of Texas Court Ruling about Affordable Care Act > Hospital Association of Pennsylvania

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Lawmakers Taking Action in Face of Texas Court Ruling about Affordable Care Act

December 27, 2018

A Texas court recently ruled that the entire Affordable Care Act (ACA) is unconstitutional. The decision is tied to the individual mandate, which had required citizens to have health insurance. Congress eliminated that mandate. Reasoning that the individual mandate is “essential” to the ACA, and inseverable, Texas federal district court judge Reed O’Connor ruled that the repeal of the penalty tied to the individual mandate has rendered the entire law unconstitutional.

For individuals who selected a health coverage plan for 2019 during the open enrollment period, that coverage is valid and will not change as a result of the court decision. All ACA provisions, including coverage protections, remain the law while legal actions play out.

Pennsylvania Governor Tom Wolf, Insurance Commissioner Jessica Altman, and Secretary of Human Services Teresa Miller have announced that they will enforce the law in Pennsylvania. Governor Wolf also has pledged to prohibit health care plans that do not cover pre-existing conditions on Pennsylvania’s ACA marketplace.

In addition, lawmakers from the state Senate Democratic Caucus say they will continue to fight to protect the key provisions of the ACA.

The caucus sponsored Senate Bills 50 and 51. Senate Bill 50 would protect health care rights for Pennsylvanians with pre-existing conditions. Senate Bill 51 aims to protect the ten essential health benefits (EHB) covered by the ACA, making those benefits mandatory under state law:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder services including behavioral health treatment and prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care

Before the enactment of the ACA, three out of five individual’s insurance policies did not cover maternity coverage and one-third did not cover substance abuse treatment.

The incoming Democrat majority in the U.S. House of Representatives is expected to act during January to intervene in the case and defend the law. This action will include reinforcing Congressional intent with respect to key consumer protections.   

HAP has consistently advocated for affordable, comprehensive coverage for as many Pennsylvanians as possible, and for protection of access to care for all Pennsylvanians. HAP will urge the Pennsylvania Congressional delegation to support efforts to preserve and strengthen coverage gains resulting from the ACA.

For more information about state efforts, please contact Stephanie Watkins, HAP’s vice president, state legislative advocacy. For information about federal efforts, contact Laura Stevens Kent, HAP’s vice president, federal legislative advocacy.

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