Wednesday, December 18, 2019

Appeals court strikes down ACA's individual mandate

Appeals court strikes down ACA's individual mandate


Just about the time the House of Representatives voted to forward their  "Impeachment resolution to the U.S. Senate, a ghost of another haunting has risen from the dead.

The Individual Mandate of the ACA assures that no one can be denied health insurance based upon previous medical conditions.


A federal appeals court on Wednesday ruled that the Affordable Care Act's individual mandate is unconstitutional, but ordered a lower court to take a fresh look at how much of the rest of the law should fall along with it.
What's next: This decision will likely keep the ACA's protections for pre-existing conditions in legal limbo well past the 2020 election.
The intrigue: Republican attorneys general have argued that congressional Republicans’ 2017 tax law, which nullified the ACA's individual mandate, made that policy unconstitutional.
  • A panel of the 5th Circuit Court of Appeals said Wednesday that it agrees.
  • Republicans, and the Trump administration, have said the courts should strike down the entire law along with the mandate.
  • The 5th Circuit wrestled during oral arguments over how much of the law to strike down, ultimately deciding to kick that question back to the lower court for a new hearing. That lower court previously said the entire law would have to go.
Yes, but: The individual mandate is now essentially toothless, and it turned out not to be particularly effective when it was in effect.
  • So, if the court is inclined to strike down the mandate alone, letting the rest of the law stand, that would be a much safer proposition than it appeared to be in 2012.
Go deeper: Government funding bill deal will repeal key ACA taxes
Why it matters: The decision is a colossal win for the health care industry.
  • If this wasn't good enough news for the industry, the deal won't address surprise medical bills — and it avoids prescription drug prices except for the CREATES Act, which helps generics get to market faster.
  • The taxes have been repeatedly delayed. And while the industry has pushed for their repeal for years, it hasn't yet been successful.
Between the lines: Voters are decidedly not asking Washington to lift industry taxes while avoiding dealing with two of the most popular health care issues, but if that's how this plays out, it's a great indicator that the industry's lobbying strength is as good as ever.
  • It's also a good sign that cost control — the intention of the Cadillac tax, a 40% excise tax on the most generous employer plans — is still not very popular with lawmakers, even as health care costs continue to rise.
  • The tax was expected to raise $200 billion over 10 years.
The other side: The industry says that the ACA taxes end up getting passed along to patients.
Go deeper:

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