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Morning Briefing

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Wednesday, Jan 2 2019

Full Issue

Health Law To Remain In Effect As Case Challenging Its Constitutionality Works Its Way Through Courts

Federal Judge Reed O鈥機onnor, who ruled in December that the health law could not stand without the individual mandate penalty, issued a stay as the ruling is appealed "because many everyday Americans would otherwise face great uncertainty" otherwise. Although O'Connor expressed certainty in his decision, many legal experts have questioned whether the ruling will hold up in higher courts.

The federal judge in Texas who ruled this month that the entire Affordable Care Act was invalid issued a stay in the case on Sunday, meaning that the law will remain in effect while the ruling is appealed. The judge, Reed O鈥機onnor of the Federal District Court in Fort Worth, said that the ruling should not go into immediate effect 鈥渂ecause many everyday Americans would otherwise face great uncertainty鈥 during an appeal. The ruling opened the door for an appeal by California and 15 other states that support the health care law. (Mervosh, 12/30)

In a ruling issued Sunday, Judge Reed O'Connor in Fort Worth wrote that he stands by his earlier conclusion that the entire law is invalidated by congressional repeal of its fines on people who remain uninsured, like a house of cards collapsing. However, because "many everyday Americans would ... face great uncertainty" if that ruling were immediately put into effect, O'Connor issued a stay to allow for appeals. (12/30)

Public health groups, Democrats and even some Republicans had warned of catastrophic cuts in health coverage if O'Connor鈥檚 Dec. 14 ruling to strike down the entire ACA had been allowed to take immediate effect. Many health policies proposed by the Trump administration, including efforts to lower drug prices and reshape hospital payment, also depend on provisions of the law. Seventeen states defending the ACA 鈥 led by California Attorney General Xavier Becerra 鈥 had asked O鈥機onnor to clarify the ramifications of his ruling so they would be able to file an immediate appeal to the 5th Circuit Court of Appeals. (Diamond, 12/30)

In the order he issued on Sunday, O'Connor expressed confidence that the appellate bench will concur with his decision that the individual mandate can't be separated from the rest of the law. "If the judicial power encompasses ignoring unambiguous enacted text鈥攖he text citizens read to know what their representatives have done鈥攖o approximate what a judge believes Congress meant to do, but did not, then policymaking lies in the hands of unelected judges and Congress may transfer politically unwinnable issues to the bench," O'Connor said. "This the Constitution does not allow. This the Supreme Court does not allow." (Luthi, 12/30)

U.S. District Court Judge Reed O'Connor ruled several weeks ago that聽the Affordable Care Act's (ACA)聽individual mandate is unconstitutional.聽Because the mandate cannot be separated from the rest of the law, the rest of the law is also invalid, he ruled. O'Connor's ruling states that the Supreme Court in 2012 upheld the mandate to have coverage because of Congress's power to tax, but the fine for failing to comply with the mandate was removed by Congress last year. He聽argues that means the mandate is no longer a tax and therefore is unconstitutional. (Birnbaum, 12/30)

Many experts expect that appellate court to disagree with O'Connor's ruling that the individual mandate聽can't be separated from the rest of the law. If O'Connor's ruling is upheld it is expected that the case would head to the Supreme Court.聽(Cummings, 12/31)

鈥淏ecause many everyday Americans would otherwise face great uncertainty during the pendency of appeal, the court finds that the Dec. 14, 2018, order declaring the individual mandate unconstitutional and inseverable should be stayed,鈥 U.S. District Judge Reed O鈥機onnor said in a filing Sunday in federal court in Fort Worth. (Wollman and Korosec, 12/30)

The mandate directing individuals to obtain health insurance or face tax penalties ends on Tuesday for most, but not all Americans. In Massachusetts, an individual mandate that has been on the books since 2006 will continue in the absence of the federal fines that had been in effect since 2014 under the Affordable Care Act but were eliminated as part of the Republican-backed tax reform law passed in 2017. (1/1)

With Congress' attempt to repeal the Affordable Care Act dead by the end of 2017, any relief the law's supporters felt were likely short-lived, as 2018 was the year the Trump administration began significantly remolding a law it fundamentally opposes. Led by HHS Secretary Alex Azar, who took the reins of the $1.2 trillion department last January, the administration charted an overarching strategy to lower drug prices and reduce spending on hospital care. Moreover, by the end of 2018, the entire Affordable Care Act was back in legal peril when a federal judge in Texas struck it down and blocked immediate appeal. (Luthi, 12/26)

Did you miss the deadline to sign up for coverage on the Affordable Care Act marketplaces? Open enrollment ended on Dec. 15, but even if you missed it, you still may be able to sign up for health insurance in 2019. But first 鈥斅燿o you need to sign up for coverage? Beginning this year, the penalty associated with Obamacare鈥檚 individual mandate drops to $0. In other words, unlike previous years, there is no tax penalty for failing to carry health insurance. (Tolbert, 12/28)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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