TAKE CARE: Advocacy Blog Series
Update on the Affordable Care Act
We are continuing our advocacy blog series meant to help you take care when it comes to important arthritis health care and coverage issues. If you are just now tuning into this series, check out our previous blog posts on accumulator adjustment programs, pharmacist gag orders, President Trump’s drug pricing blueprint, drug rebates, and premium increases.
This week, we break down a recent legal challenge to the Affordable Care Act (ACA). A court case was recently thrown into the spotlight as a result of the administration’s decision to file a brief essentially arguing that federal courts should find the ACA’s protection for people with pre-existing conditions unconstitutional. Read on to learn more.
What’s the legal challenge about?
In March, a coalition of attorneys general from nearly two dozen states filed a complaint in a United States district court in Texas arguing that the ACA’s health insurance reforms, and many of the consumer protections such as prohibiting the denial of coverage based on a pre-existing condition, were unconstitutional. The lawsuit argues these reforms are unconstitutional because Congress repealed the individual mandate last December in the tax reform bill.
What does the individual mandate have to do with this case?
In their complaint, the attorneys general lean on the 2012 Supreme Court decision upholding the constitutionality of the individual mandate under the ACA, which the Court ruled may be reasonably characterized as a tax penalty. Since the individual mandate was effectively eliminated last year, the attorneys general believe the individual mandate and the rest of the Affordable Care Act is now unconstitutional.
How did the administration react to the lawsuit?
The lawsuit grabbed headlines in June due to a surprising court filing by the Department of Justice urging the district court to strike down the individual mandate as well as key consumer protections, such as the prohibition on refusing to cover or charge higher premiums to individuals with a pre-existing condition.
Offering support for the lawsuit is highly unusual: regardless of the party in power, the Administration has a constitutional responsibility to ensure laws are faithfully executed and is expected to defend these laws when they are challenged in court.
What are the immediate consequences?
Attorneys general from a number of other states are expected to defend the federal law. A decision by the Texas district court is unlikely for many weeks; when a decision is reached it will likely be appealed. In the meantime, the consumer protections in the ACA remain law and insurers may not deny coverage or charge higher premiums to individuals with pre-existing coverage.
What is the Arthritis Foundation doing in response to the administration’s action?
The Arthritis Foundation is monitoring developments in the court case, and a decision is still many months away. However, we are deeply concerned that the Administration has argued important patient protections - such as prohibiting pre-existing condition exclusions - should be eliminated from current law. We continue to advocate before Congress and the Administration for policies consistent with our principles for health reform, which continue to guide our approach to legislative and regulatory proposals affecting the health insurance markets.
We understand that health care costs continue to be a complex issue for patients and all parts of the health care industry. We will continue to work diligently to identify solutions that put patients first. If you’d like to stay informed of federal and state-based health care issues, consider signing up to be an Advocate. Becoming a part of our Advocacy grassroots network is an easy way to get involved and stay informed.