What a Texas-based Court Ruling on the ACA Could Mean for You

By Lynne Ide | 

A key Affordable Care Act (ACA)-related court case (Texas v. Azar) could be decided as soon as this month.  The ruling in this Affordable Care Act repeal lawsuit could strike down the entire ACA – or uphold it.   

Either way, it is predicted that the losing parties will ask the Supreme Court to take up the case.  Read more here.  

You might react to this news by saying:

  • So what?  It sounds like there will be no real court decision for a while 
  • I am not worried, because I don’t use the ACA 
  • Connecticut has pretty good protections against ACA erosion, so I am okay 
  • I can’t keep up with all these threats to the ACA, just tell me what I can do 

A decision against the ACA could affect many Connecticut residents.  Here’s how:

  • Yes, Connecticut has passed laws to codify some provisions in the ACA, such as: the 10 essential health benefits, parents keeping children up to age 26 on their health plan, and pre-existing condition protections.  But these state protections only cover people who are in fully-insured plans, and in our state over 60% of people with employer coverage are in self-insured plans, which cannot be regulated by state law. 
  • If your employer has a self-insured plan, which is not regulated by state law, a strike down of the ACA would get rid of key protections, such as: the 10 essential health benefits, parents keeping children up to age 26 on their health plan, and pre-existing condition protections — unless the employers voluntarily decide to include them in their plans. 
  • People who receive subsidies to purchase their insurance on the state’s health insurance exchange, Access Health CT, would lose those ACA subsidies.  That’s an estimated 75,000 or more people impacted. 
  • Low-income adults who qualify for the ACA’s expanded Medicaid program (called HUSKY D) would lose their health care coverage – an estimated 267,000 people. 

What could be done to protect people?

If the ACA is struck down in the Texas v. Azar case, the Supreme Court could act to stop unravelling the law until they have a chance to rule on the case.  Read more here

Or – individual states could step in to do what they can to protect people.  The problem is: 

  • Our state can’t do much without using state money to preserve the ACA-expanded Medicaid (HUSKY D) coverage – or provide state subsidies to replace the ACA subsidies offered to qualified individuals purchasing plans via Access Health CT.   
  • And – we still cannot tell self-insured health plans to abide by state statutes mandating certain coverage protections. 

What can I do?

Connecticut residents should be prepared to stand up and call for swift action by our elected leaders when this decision comes down – either to reaffirm the decision to preserve the protections in the ACA, as well as the expanded coverage options and subsidies – or to call on the Supreme Court take action to put a halt to ACA unravelling until they decide the case. 

And – we can call on our Congressional delegation and state legislators to take action to do what they can to make sure people are not harmed.