Clouds are once again hanging over the Affordable Care Act (ACA), requiring us to remain vigilant in protecting the health care gains we have made since the landmark legislation became law in 2010. On Friday, December 14, a federal judge in Texas ruled that the ACA became unconstitutional when Congress voted last year to eliminate the individual mandate tax penalty, effective next month.
The California Attorney General has already vowed to challenge the ruling saying we can’t “stand for this backwards and dangerous determination.” If the Texas ruling is ultimately upheld by the Supreme Court, health care subsidies and Medicaid expansion would go away, throwing the health care system into chaos.
L.A. Care gained as many as 700,000 members as a result of Medicaid expansion and our participation in the ACA marketplace. Without health care coverage, these people would be forced to return to emergency rooms for much more expensive care. Some states will be in a bigger bind given they shut down safety net programs when the law was enacted. It will take time to get them operating again, and in the meantime, the disruption will be devastating.
The law will remain in place, pending appeals. But last week’s Texas ruling has served to create further confusion about the law that has been under attack since it was enacted in 2010. The Supreme Court has rejected two previous challenges in 2012 and 2015. I am confident that the high court will once again rule in favor of the ACA, if and when it takes up this Texas ruling.