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Friday, December 21, 2018

A new court ruling has the potential to change the future of the Affordable Care Act (ACA or Obamacare). While nothing is changing immediately, it’s important for all people, including cancer patients, survivors, and their loved ones to understand what this means for them.

The Affordable Care Act

In 2010, the ACA was passed into law. Although we’ve seen multiple attempts to repeal the law, the ACA has remained in place for the past eight years and 20 million people have gained insurance as a result.

Tax Cuts and Jobs Act
Here’s a quick summary of how the Tax Cuts and Jobs Acts affects health care coverage in the United States:

  • In December 2017, the U.S. Congress passed the Tax Cuts and Jobs Act into law.
  • Among other provisions, the law repealed the ACA’s “individual shared responsibility penalty.”
  • This individual shared responsibility penalty imposed a penalty through a tax payment for individuals who did not secure health care coverage.
  • This provision of the ACA was to ensure that people who were both healthy and those living with chronic illnesses would purchase health care coverage.
  • This was done to ensure a “balance the marketplace”.
  • If only people experiencing illness purchased coverage, coverage would be very expensive.
  • While the bill did not repeal the tax penalty, it reduced the penalty to zero which means that individuals would owe the government nothing if they choose not to secure health care coverage. 

Texas vs. the United States

Earlier this year, the Texas Attorney General, along with 18 other state attorneys general two governors, and two individuals filed a lawsuit in the state of Texas, alleging that the ACA has become unconstitutional since the repeal of the individual shared responsibility penalty. The plaintiffs of this case argue that the repeal of the coverage mandate makes the entire law unenforceable.

The Ruling

On December 14th, 2018, a federal judge in the U.S. District Court in Texas ruled in favor of the plaintiffs, issuing a decision that the entire law is unconstitutional because of the repeal of the individual shared responsibility penalty.

It is very important to note that the ruling does not take effect immediately. The December 14th ruling is being appealed and the ACA will remain in place while the ruling is appealed, and all those who purchased coverage through the exchange and who are covered by Medicaid will continue to have coverage and benefit from the ACA protections.

What next?

The 16 state attorneys general who intervened in the case to defend the ACA have announced that they will appeal the decision, sending the case up to the circuit court and then very likely to the Supreme Court for debate. The Supreme Court has already upheld the law against challenges in cases in 2012 and in 2015, but there is still a risk that the addition of the courts newest justice could sway the decision against the ACA. Throughout efforts to repeal the individual mandate tax, Congress worked to keep the rest of the law in place. Legal experts and patient advocates alike hope that the actions of Congress to protect the law will influence the circuit and Supreme Court to protect the law as well.

What could this mean to you and other people with chronic or life-threatening illness?

If the ACA is ruled unconstitutional and is therefore dismantled, it could have devastating effects on access to care, removing many essential patient protections that cancer patients and survivors depend on. Insurers could return to the practice of denying coverage to certain people, canceling coverage midyear, charging higher premiums to older people or those with pre-existing conditions, setting lifetime or annual limits, and refusing coverage for essential health benefits like prescription drugs, mental health care, emergency care, and more.

Now is the time to contact your members of Congress and ask them to uphold their promise and protect ACA provisions that ensure cancer patients and survivors continue to have access to quality, comprehensive, and affordable care.

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