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New Orleans Appeals Court is Next Step in Determining Affordable Care Act’s Future


By Graciela Rayome, guest contributor to the DHA Blog
A federal appeals court in New Orleans is currently contemplating the future of the Affordable Care Act (ACA) in reviewing Texas v. the U.S. The U.S. Court of Appeals for the 5th Circuit will decide by the fall of this year whether or not to uphold the 2018 ruling of a federal court judge in Texas that the ACA cannot stand on its own and is unconstitutional since Congress last December repealed the individual mandate. Questions such as whether or not the ruling would only apply to the plaintiff states, or if parts of the ACA would be retained, are currently unanswered. However, the case is expected to make its way to the Supreme Court regardless of the outcome. Although no injunction was included in the order and the ACA is still operational, should this ruling be upheld ultimately by the Supreme Court, the ACA would be abolished in its entirety. 
Should the ACA be ultimately struck down, thousands of Delawareans and millions of Americans (as DHA has discussed in a previous blog post) will be negatively affected. It is estimated the number of uninsured could jump 65% as those who were insured in healthcare exchanges lose coverage. The number of uninsured could rise further should states roll back Medicaid expansions as a result of lost federal funding. Those without health insurance are less likely to seek the checkups and preventative care that contribute to better overall health. With less people covered by insurance, healthcare providers will see their costs for uncompensated care rise as they begin to treat more and more uninsured patients. This would put further upward pressure on health insurance premiums and out-of-pocket expenses for consumers. 
Regardless of the court’s decision, it’s important to note that Delaware has taken important steps to write key consumer protection provisions of the ACA into Delaware law. Senator Trey Paradee and Representative Bill Bush sponsored a bill (SB 35) this session to prohibit insurance plans from denying or limiting coverage for an individual based on pre-existing conditions. DHA supported SB 35, which has passed both the Senate and House and is awaiting the Governor’s signature.    
DHA will continue to provide updates on the court cases that may impact the future of the ACA.
ACA Timeline of Major Actions 
2010: The Affordable Care Act is passed, establishing the healthcare marketplace and guaranteeing patient protections in health insurance plans.
2012: The Supreme Court upheld the constitutionality of the Affordable Care Act and its individual mandate by connecting the mandate to Congress’ ability to levy taxes in NFIB v. Sebelius 
2015: The Supreme Court upheld the ACA’s provision of healthcare subsidies to all qualifying Americans in King v. Burwell
2017: A tax cut package is passed by Congress eliminating the ACA’s financial penalty for failing to have healthcare insurance or coverage.
2018: A coalition of states, led by Texas, file a case against the United States government which argues that the ACA’s individual mandate is unconstitutional, and as the mandate is essential to the ACA, the entire law should be struck down. 
December 2018: A Texas judge sides with the plaintiffs and rules that the ACA cannot stand without a mandate penalty. Other states appeal the ruling.
July 2019: The 5th Circuit Court of Appeals in New Orleans hears Texas v. the U.S.  
Graciela Rayome is a senior at the University of Delaware, studying Public Policy and Public Health and is currently interning at the Delaware Healthcare Association.