The future of the Affordable Care Act remains in limbo after the Supreme Court denied a motion to expedite its consideration of the health law’s future. The decision, announced on Tuesday, makes it unlikely that the court will hear the case before November’s elections.
In December, an appeals court ruled that the individual mandate was unconstitutional, partially affirming a Texas judge’s ruling that the entire ACA was unconstitutional. The appeals court did not decide what that means for the rest of the health law, sending the case back to the district court to determine if other portions of the ACA are unconstitutional. The case, Texas et al v U.S. et al, was originally filed in 2018 by 20 Republican-led states.
On January 5, California, Washington D.C. and 19 other Democratic-led states filed a petition for the Supreme Court to consider the case on an expedited basis. Normally, the Supreme Court wouldn’t consider hearing the case until March of 2020 at the earliest. With the expedited briefing, Democrats hoped the court would hear the case in the next term, preparing insurers for next year’s enrollment and bringing the topic to the forefront as Election Day approaches.
The states wrote that without a decision, individuals, businesses and states will face “crippling uncertainty” going into 2021.
Insurance trade group America’s Health Insurance Plans (AHIP) and 33 hospital associations also filed comment with the Supreme Court on the case. Their concern was not so much with the striking down of the individual mandate, as it was the uncertainty of the entire ACA’s future after the appeals court decided to remand the case back to the district court.
For example, AHIP wrote, it could affect hundreds of other measures that have nothing to do with the individual mandate, including requirements to provide preventive care at no out-of-pocket cost, guaranteed coverage for individuals with preexisting conditions, and funding for expanded Medicaid programs in 37 states.
“Invalidation of the ACA would wreak havoc on the health care system,” AHIP wrote. “The ACA is not a tapestry that unravels by pulling upon a single thread (i.e., the individual mandate). Rather, the ACA’s multitude of wide-ranging reforms … affect every health insurance market (not just the individual market) and every American with coverage (not just those who purchased coverage on the exchanges).”
Hospital associations added that the uncertainty may lead to slower adoption of new healthcare models, such as accountable care organizations, and will lead to bond rating downgrades that could affect hospitals’ ability to raise capital.
The Supreme Court will return for its next term in October.
Photo credit: Mykola Velychko, Getty Images
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