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Joe Raedle/Getty Images What consumers need to know about the Fifth Circuit Court of Appeals ruling on Obamacare.
What should the approximately 20 million Americans with Affordable Care Act insurance be doing after federal appellate judges voided a portion of Obamacare?
Taking a deep breath, experts say.
Make no mistake, any ruling that deals with health coverage is serious stuff. But consumers with plans under the law — also known as Obamacare — should know that nothing changes immediately while the case wends through the courts.
In a 2-1 decision Wednesday, judges in the Fifth Circuit Court of Appeals said the law’s requirement that most Americans must have health insurance or pay a fee is unconstitutional. That’s the law’s so-called “individual mandate.” Congress in 2017 reduced the mandate’s fee for people without insurance to $0.
But that’s only one aspect of the sweeping law. The Affordable Care Act also imposed health insurance market reforms, like outlawing coverage denials for pre-existing conditions. It subsidized certain plans and encouraged states to adopt the federal government’s widened Medicaid program for low-income residents.
The circuit ruling affirmed a lower court’s decision that the individual mandate was unconstitutional. The Texas federal judge, Reed O’Connor, said because the mandate was invalid, the entire law was invalid.
The appeals court didn’t go that far. It sent the case back to O’Connor, saying the judge needed to decide whether there were constitutional parts of the Affordable Care Act that could be cut away from the unconstitutional mandate.
Does the court ruling mean the Affordable Care Act is still in effect?
“Yes it is. All of it,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation, a nonprofit organization that provides nonpartisan analysis on public health matters.
“Nobody’s coverage is going to change,” she said — it’s just going to keep a lot of lawyers busy for the foreseeable future.
California Attorney General Xavier Bercerra, one of the lawyers leading the charge for the 21 states trying to keep the law intact, said he would appeal the ruling to the U.S. Supreme Court.
The high court doesn’t have to take up the appeal. It could deny the petition, which would mean the case would go back to O’Connor for review. (Four of the U.S. Supreme Court’s nine justices need to decide to hear the appeal.)
It remains to be seen whether the Supreme Court will pick up any appeal. Remanding the case back to the Texas court would draw out the process even longer.
“Remand is going to mean many more years of litigation,” Katie Keith, a professor at the Georgetown University Law Center. “For real people, real patients and consumers, nothing is changing in the near future,” she later added.
What does the court decision mean for my Obamacare premium?
“No change,” Pollitz said, noting 2020 rates were locked in months ago. “Take a deep breath. Pay your first month’s premium so your 2020 coverage is ensured,” she said.
Any rate changes this year would only occur if someone has a change in their personal financial situation from events like a change in income or a job loss. Changing income levels can affect the size of the tax credit people receive to lower their monthly insurance payment, Pollitz said.
Any widescale premium changes would only happen in 2021 and those rates are typically ironed out in the fall, she said.
What if the courts ultimately strike down Obamacare? How can I start planning back-up health care plans?
It’s impossible to predict future court action. Besides, a person’s own money situation might change too — they could score a job that offers health insurance, for example.
In any case, it’s a good idea to stay informed on politics going into the 2020 elections, Pollitz said — and not just the presidential election.
Federal lawmakers most surely have a critical say on the funding and future direction of the program, she said. Presidents also pick Supreme Court justice candidates who are confirmed by the Senate, increasingly along bitter partisan lines.
But Pollitz said concerned consumers need to remember state politics are important too. State governors and attorney generals can decide to challenge or defend the law, and state officials are the ones who decide whether to join the broadened Medicaid program, she noted.
More than a dozen states — including Florida, a perennial swing state — have not adopted the expansion, according to Kaiser Family Foundation statistics.
America is coming up on the 10-year anniversary of the Affordable Care Act’s March 2010 enactment. Lawyers and politicians have fought over the law since then, Pollitz said.
“I guess people need to get used to the background noise and keep going,” she added.
