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Supreme Court Ruling Should Help Affordable Care Act Stick: Health Care Lawyer

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What You Need to Know

  • The court ruled 7-2 that Texas and other states that oppose the ACA system have no standing to sue over the ACA individual coverage ownership mandate.
  • Stephen Lucke says the majority went to great lengths to save the ACA.
  • Another health policy watcher says the next big health policy news will be about federal surprising billing law regulations.

A health care lawyer says the new U.S. Supreme Court ruling on the constitutionality of the Affordable Care Act is about more than procedural rules.

Stephen Lucke, a partner at law firm of Dorsey & Whitney and the co-chair of the firm’s health litigation group, contends in a commentary on the ruling that the court majority clearly meant to keep the ACA in place.

California v. Texas Background

Texas, other states that oppose the ACA and two self-employed Texas residents went to court in an effort to block the ACA “individual shared responsibility” provision, or individual coverage mandate. The provision requires some people to have what the government classifies as “minimum essential coverage,” or adequate health coverage, or else pay a penalty.

Congress set the penalty at zero, in a provision in the Tax Cuts and Jobs Act of 2017.

Texas and other members of its coalition argued that the provision is an unconstitutional requirement for affected people to buy a commercial product.

Supreme Court members ruled 7-2 Thursday, in the case California v. Texas (Case Number 19-840), that the federal health law can stay in place, because the zeroed-out mandate can do the states and individual plaintiffs no injury that’s traceable to the mandate.

Because the mandate provision can cause Texas and the other plaintiffs no harm, those plaintiffs have no standing to sue over the provision’s constitutionality, the majority contended.

Justice Stephen Breyer wrote the opinion for the majority.

Justice Clarence Thomas sided with the majority and wrote a concurring opinion.

Justice Samuel Alito Jr. opposed the ruling and wrote a dissenting opinion.

Lucke’s View

Lucke maintains in the commentary that the majority’s ruling is about more than whether states and individuals have standing to sue over zeroed-out penalties.

This is the third time the Supreme Court has rebuffed challenges to the ACA, Lucke notes.

“The continued survival of the ACA despite formidable legal challenges suggests that the courts are unlikely to substantially limit its reach,” Lucke says. “Indeed, both the concurrence and dissent commented on the lengths to which — in their view — the court acted to ‘save’ the legislation. Although the court’s latest decision rests on constitutional grounds that limit the court’s ability to intervene in matters in which no injury is traceable to the challenged conduct, the fact that the Affordable Care Act has now survived a ‘trilogy’ of challenges suggests that until Congress acts, its provisions are here to stay.”

Turmoil Avoided

Kathryn Bakich, national director of health care compliance at Segal, a human resources and benefits consulting firm, says in a commentary that the Supreme Court succeeded at turning what could have been a bomb into a blip.

Some benefits specialists and employer see the ACA as a complicated, expensive, harmful effort by the federal government to control the health insurance market.

Bakich suggests that a Supreme Court decision suddenly overturning all of the ACA, as Texas and other members of its coalition had requested, would have been damaging.

A broad Supreme Court ruling in favor of the Texas coalition “would have thrown one-sixth of the U.S. economy into chaos,” she says. “Insurance programs, including those offered by employers, would have been thrown into turmoil.”

Coming Up Next

Bakich predicts the next big federal health policy news will involve the No Surprises Act — a new federal law that seeks to impose price transparency requirements on health care providers, insurance brokers and others, and to set rules for how health care providers bill patients who seek care outside of their health plans’ provider networks.

“I am expecting [draft] regulations any minute now,” Bakich says.

(Image: Ormalternative/Shutterstock)