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Supreme Court Keeps ACA-Killer Case Off Fast Track

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The U.S. Supreme Court today refused to act quickly to free states that like the Affordable Care Act, U.S. health insurers, and other ACA watchers from suspense about whether the ACA will live or die.

The court today postponed review of the case formerly known as Texas v. the United States, or Texas v. Azar, until at least next fall.


The court delivered that decision in a 16-word message included in an order list document posted today. The message did not provide an explanation for the ruling.

The Case Formerly Known as Texas v. the United States

Officials in Texas and other states that oppose the Affordable Care Act filed a lawsuit in a federal court in Texas that challenged the constitutionality of the ACA individual coverage mandate.

The plaintiffs argued, in a case which originally was known as Texas v. the United States, or Texas v. Azar, that, because the individual mandate provision is unconstitutional, and because the ACA includes no provision for keeping the rest of the law in place if one part is tossed out, all of the ACA must die.

The U.S. District Judge Reed O’Connor ruled in favor of the plaintiffs in December 2018.

A three-judge panel at the 5th U.S. Circuit Court of Appeals upheld the lower-court ruling in December 2019. The 5th Circuit panel sent the judge back down to the district court. The panel asked the lower-court judge to look at whether killing the individual mandate provision in the ACA should really kill of the ACA.

Officials in California, New York state and other states that support the ACA asked the Supreme Court to take up the case this spring, without letting the case go back to the district court level, to provide the final ruling on the outcome of the case as quickly as possible.

ACA supporters and America’s Health Insurance Plans have argued that public health plan managers and commercial health insurers need to know the fate of the ACA as quickly as possible.

Lawyers for the administration of President Donald Trump and states like Texas have argued that there is no need for the Supreme Court to consider the case on an emergency basis, because the courts have already stayed the effects of the district court ruling.

Robert Henneke, a representative for the Texas Public Policy Foundation, has argued in a “friend of the court” brief that there is no reason for the Supreme Court to rush to hear the case, and that California, Texas and the petitioners have been trying to politicize the case.

”Political considerations, such as petitioners’ desires to deflect attention away from the current efforts to replace the Affordable Care Act with single-payer Medicare for All, are not exigent circumstances that warrant expedition of this case, as this court is not a political branch of government,” according to Henneke.

At the Supreme Court, one of the cases relating to the ACA individual mandate litigation is called California v. Texas and has the case number 19-840.

Another case is called United States House of Representatives v. Texas and has the case number 19-841.

Although the Supreme Court has declined to consider the case immediately, it could still take up the case after the lower court completes its deliberations.

A Reaction

Margaret Murray, the chief executive officer of the Association for Community Affiliated Plans, said in a statement about the Supreme Court ruling will hurt health plans’ efforts to provide coverage.

“By declining to take up this case in an expedited manner, the Supreme Court leaves in place the cloud of uncertainty that hangs over the Affordable Care Act,” Murray said in the statement. “That uncertainty has already spread across the health care system. Plans will postpone investment and innovation in the individual market, dampening competition. Consumers will be left to wonder about the fate of important consumer protections against discrimination on the basis of pre-existing conditions, lifetime coverage caps, and rescissions of coverage.”

— Read Appeals Court Rejects Health Insurers’ Plea for Billions in Subsidy Moneyon ThinkAdvisor.

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