{"id":3683,"date":"2019-07-09T04:18:37","date_gmt":"2019-07-09T09:18:37","guid":{"rendered":"https:\/\/wwwqa.cencalhealth.org\/?p=3683"},"modified":"2023-03-24T00:02:00","modified_gmt":"2023-03-24T05:02:00","slug":"aca","status":"publish","type":"post","link":"https:\/\/wwwqa.cencalhealth.org\/news\/2019\/07\/aca\/","title":{"rendered":"Federal Appeals Court Takes Up Case That Could Upend U.S. Health System"},"content":{"rendered":"

Kaiser Health News
\nJulie Rovner<\/span><\/p>\n

The fate of the Affordable Care Act is again on the line Tuesday, as a federal appeals court in New Orleans takes up a case in which a lower court judge has already ruled the massive health law unconstitutional.<\/p>\n

If the lower court ruling is ultimately upheld, the case,\u00a0Texas v. United States<\/a>, has the potential to shake the nation\u2019s\u00a0entire health care system<\/a>\u00a0to its core. Not only would such a decision immediately affect the estimated 20 million people who get their health coverage through programs created under the law, ending the ACA would also create chaos in other parts of the health care system that were directly or indirectly changed under the law\u2019s multitude of provisions, such as calorie counts on menus, a pathway for approval of generic copies of expensive biologic drugs and, perhaps most important politically, protections for people with preexisting conditions.<\/p>\n

\u201cBillions of dollars of private and public investment \u2014 impacting every corner of the American health system \u2014 have been made based on the existence of the ACA,\u201d said a\u00a0friend-of-the-court brief<\/a>\u00a0filed by a bipartisan group of economists and other health policy experts to the 5th Circuit Court of Appeals. Upholding the lower court\u2019s ruling, the scholars added, \u201cwould upend all of those settled expectations and throw healthcare markets, and 1\/5 of the economy, into chaos.\u201d<\/p>\n

Here are five important things to know about the case:<\/p>\n

It was prompted by the tax bill Republicans passed in 2017.<\/p>\n

The big tax cut bill passed by the GOP Congress in December 2017\u00a0eliminated the penalty<\/a>\u00a0included in the ACA for failure to maintain health insurance coverage. The lawsuit was filed in February 2018 by a group of Republican attorneys general and two governors. They argued that since the Supreme Court had upheld the ACA in 2012 specifically because it was a valid exercise of Congress\u2019 taxing power, taking the tax away makes the entire rest of the law unconstitutional.<\/p>\n

Last December, Judge Reed C. O\u2019Connor\u00a0agreed with the Republicans<\/a>. \u201cIn some ways the question before the court involves the intent of both the 2010 and 2017 Congresses,\u201d O\u2019Connor wrote in his decision. \u201cThe former enacted the ACA. The latter sawed off the last leg it stood on.\u201d<\/p>\n

State and federal Democrats are defending the law.<\/p>\n

Arguing that the rest of the law remains valid is a group of Democratic attorneys general, led by California\u2019s Xavier Becerra.<\/p>\n

\u201cOur argument is simple,\u201d said Becerra\u00a0in a statement last Friday<\/a>. \u201cThe health and wellbeing of nearly every American is at risk. Healthcare can mean the difference between life and death, financial stability and bankruptcy. Our families\u2019 wellbeing should not be treated as a political football.\u201d<\/p>\n

The Democratic-led\u00a0House of Representatives<\/a>\u00a0has also been granted \u201cintervenor\u201d status in the case.<\/p>\n

The Trump administration has taken several positions on the lawsuit.<\/p>\n

The defendant in the case is technically the Trump administration. Traditionally, an administration, even one that did not work to pass the law in question, defends existing law in court.<\/p>\n

Not this time. And it is still unclear exactly what the administration\u2019s position is on the lawsuit. \u201cThey have changed their position several times,\u201d Sen. Chris Murphy (D-Conn.) told reporters on a conference call Monday.<\/p>\n

When the administration first weighed in on the case, in June 2018, it said it believed that without the tax penalty only the provisions most closely connected to that penalty \u2014 including requiring insurers to sell policies to people with preexisting conditions \u2014 should be struck down. The rest of the law should stay, the Justice Department argued.<\/p>\n

After O\u2019Connor\u2019s ruling, however, the\u00a0administration changed its mind<\/a>. In March, a spokeswoman for the Justice Department said it had \u201cdetermined that the district court\u2019s comprehensive opinion came to the correct conclusion and will support it on appeal.\u201d<\/p>\n

Now it appears the administration is shifting its opinion again. In a\u00a0filing with the court<\/a>\u00a0late last week, Justice Department attorneys argued that perhaps the health law should be invalidated only in the GOP states that are suing, rather than all states. It is unclear how that would work.<\/p>\n

Legal scholars \u2014 including those who oppose the ACA \u2014 consider the case dubious.<\/p>\n

In a brief filed with the appeals court,\u00a0legal scholars<\/a>\u00a0from both sides of the fight over the ACA agreed that the lawsuit\u2019s underlying claim makes no sense.<\/p>\n

In passing the tax bill that eliminated the ACA\u2019s tax penalty but nothing else, Congress \u201cmade the judgment that it wanted the insurance reforms and the rest of the ACA to remain even in the absence of an enforceable insurance mandate,\u201d wrote law professors Jonathan Adler, Nicholas Bagley, Abbe Gluck and Ilya Somin. Bagley and Gluck are supporters of the ACA; Adler and Somin have argued against it in earlier suits. \u201cCongress itself \u2014 not a court \u2014 eliminated enforcement of the provision in question and left the rest of the statute standing. So congressional intent is clear.\u201d<\/p>\n

It could end up in front of the Supreme Court right in the middle of the 2020 election.<\/p>\n

Depending on what happens at the appeals court level, the health law could be back in front of the Supreme Court \u2014 which has upheld the health law on other grounds in 2012 and 2015 \u2014 and land there in the middle of next year\u2019s presidential campaign.<\/p>\n

Democrats are already sharpening their rhetoric for that possibility.<\/p>\n

\u201cPresident Trump and Republicans are playing a very dangerous game with people\u2019s lives,\u201d Senate Minority Leader Chuck Schumer told reporters on a conference call Monday.<\/p>\n

Murphy said he is most concerned that if the lower court ruling is upheld and the health law struck down, Republicans \u201cwon\u2019t be able to come up with a plan\u201d to put the health care system back together.<\/p>\n

\u201cRepublicans tried to come up with a replacement plan for 10 years, and they couldn\u2019t do it,\u201d he said.<\/p>\n

Kaiser Health News<\/a>\u00a0(KHN) is a national health policy news service. It is an editorially independent program of the\u00a0Henry J. Kaiser Family Foundation<\/a>\u00a0which is not affiliated with Kaiser Permanente.<\/p>\n","protected":false},"excerpt":{"rendered":"

Kaiser Health News Julie Rovner The fate of the Affordable Care Act is again on the line Tuesday, as a federal appeals court in New Orleans takes up a case in which a lower court judge has already ruled the massive health law unconstitutional. If the lower court ruling is ultimately upheld, the case,\u00a0Texas v. […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","inline_featured_image":false,"footnotes":""},"categories":[5,7],"tags":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/posts\/3683"}],"collection":[{"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/comments?post=3683"}],"version-history":[{"count":1,"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/posts\/3683\/revisions"}],"predecessor-version":[{"id":3685,"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/posts\/3683\/revisions\/3685"}],"wp:attachment":[{"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/media?parent=3683"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/categories?post=3683"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/tags?post=3683"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}