Important ACA court case heard in New Orleans

By Rosana Ferraro |

On Tuesday, July 9, a critical court case about the Affordable Care Act (ACA) was heard in New Orleans. Known as Texas v. Azar (or Texas v. United States), the case could change health care across the country.

What’s Texas v. Azar all about?

Essentially, the Texas v. Azar case challenges the very existence of the Affordable Care Act. What could the outcomes be? The court could rule that the Affordable Care Act is unconstitutional and wipe out the law wholesale, or only rule that certain parts of the law are unconstitutional. On the other hand, the three-judge panel could decide that the Affordable Care Act is still the law of the land. Here’s 5 facts you need to know about the case.

What’s already happened?

Back in December 2017, Congress passed a tax bill that included a repeal of the individual mandate. After months of failing to repeal the ACA, Congress then gutted one piece of the law – the individual mandate, using the tax bill to do it.

The individual mandate says that everyone – barring certain people who qualify for exemptions – has to have health insurance. A penalty is charged at tax time to those who don’t carry health insurance coverage for at least 9 months of the year. The individual mandate was considered a crucial part of the law – the “three legged stool” of the ACA – along with subsidies and ensuring that people with pre-existing conditions can’t be denied coverage. Learn more about the “three-legged stool” of the ACA in this video.

The December 2017 tax bill made the individual mandate penalty $0 – essentially getting rid of it. Then, in February 2018, Texas’s Attorney General and the Republican Attorneys General of 19 other states came together to file a lawsuit to invalidate the entire Affordable Care Act – trying to make the argument that because the individual mandate is effectively gone, the whole Affordable Care Act should be invalid. In June 2018, 16 Democratic Attorneys General, led by California’s Attorney General, intervened to defend the Affordable Care Act.

In December 2018, Federal District Judge Reed O’Connor decided that the Affordable Care Act is invalid. The case being heard now in July 2019 is an appeal of that decision.

So what happened at the hearing?

In New Orleans, at the Fifth Circuit Court of Appeals, oral arguments were heard by a three-judge panel – two Republican judges and one Democratic judge. Judging by the line of questions by the 2 Republican judges, some analysts fears that the judges will overturn part or all of the Affordable Care Act. But it’s too soon to tell what the ruling will be and what will happen.

It is likely, whatever the ruling, that whichever side loses the appeal will try to take the case to the Supreme Court. We will be closely following this case, but until then, here’s more on what happened in the court room:

• AP News reports on what happened at the hearing
• CNN followed the hearing live and has extensive coverage from the day

What’s at risk in Connecticut?

Many people here in our state could be hurt by the decision in this case. If the ACA remains the law, nothing would change. BUT if the ACA is struck down in whole or in part, thousands would see negative consequences regarding their health care.

• Over 78,000 state residents will lose subsidies that help them buy coverage on Access Health CT, the state exchange;
• Roughly 260,000 people enrolled in HUSKY D (Medicaid expansion) in the state could lose coverage;
• About 65,000 seniors on Medicare would lose the critical help the ACA provided to help them afford their prescription drugs (by fixing the Medicare Part D prescription benefit “donut hole”); and,
• The state stands to lose $1.85 billion in federal funding if the ACA is ruled unconstitutional.

A Deeper Dive

Want to learn more about this case and what’s going on? Here’s a few handy articles and analyses for a deeper dive:

• The latest legal challenge to the Affordable Care Act, explained, from Vox (July 10, 2019)
• Explaining Texas v. U.S.: A Guide to the 5th Circuit Appeal in the Case Challenging the ACA, from Kaiser Family Foundation (July 3, 2019)
• Nicholas Bagley, a legal expert, on his view of the hearing: Silver bullets, blue pencils, and the future of the ACA (The Incidental Economist, July 10, 2019)
• The Health 202: The Obamacare lawsuit, by the numbers (Washington Post, July 10, 2019)