On March 25, the Department of Justice (DOJ) filed a letter to the U.S. Court of Appeals for the Fifth Circuit stating it agreed with the ruling of the Federal District Court for the Northern District of Texas in United States v. Texas invalidating the entire Affordable Care Act (ACA). In this case, the lower court ruled that as a result of Tax Cuts and Jobs Act provision reducing the individual mandate penalty to $0, the mandate was unconstitutional. Furthermore, the lower court ruled that the entire ACA was invalid as a result. The DOJ had previously argued in District Court that only the individual mandate and pre-existing condition protections should be invalidated, while the rest of the law should remain intact. The Arc strongly supports fully overturning the District Court ruling and has signed onto an amicus brief.
On February 13, the House Energy and Commerce Committee’s Health Subcommittee held a hearing on proposed legislation that would reverse current administration policies on implementation of the Affordable Care Act (ACA), such as the reduction in funding for programs that assist with enrollment and the regulation allowing wider use of short-term limited duration health insurance plans. Witnesses included Grace-Marie Turner, President, Galen Institute; Katie Keith, Associate Research Professor and Adjunct Professor of Law, Georgetown University; and Jessica K. Altman, Commissioner, Pennsylvania Insurance Department. Visit the Committee website for testimony and archived video of the hearing.
On December 14, a federal judge ruled that the Affordable Care Act (ACA) is unconstitutional as a result of the provisions in the Tax Cuts and Jobs Act that removed the penalty for individuals who do not purchase health insurance. The ruling further argued that the entire law was invalid because the provision requiring people to purchase health insurance was unconstitutional. The decision is likely to be appealed and the law remains in place as the case makes its way through the judicial process. The decision came the day before open enrollment ended in most states. It is estimated that, if the decision stands, more than 17 million people would lose health insurance. Many of the law’s most popular provisions would end, including the protections for people with pre-existing conditions, allowing parents to cover their children until age 26, eliminating annual and lifetime limits on coverage, and other provisions. The ACA provides many critical protections for people with disabilities and The Arc will continue to support the law.
Now is the time for individuals who are uninsured or are looking for affordable health insurance to investigate the private health insurance plans available through state marketplaces (to find your state information visit the health care website). During open enrollment a person can purchase private health insurance through the marketplace in each state. There may also be financial assistance to help with health care costs available to people with low and moderate incomes. It is also important for people who currently have insurance through the marketplace to look at the plan to determine if it will continue to meet their needs. Individuals who do not take action will be automatically re-enrolled in the current plan. Re-enrollment is also an important opportunity for people to report any changes in income. To learn more, read The Arc’s blog post. Open enrollment ends on December 15, 2018.
Now is the time for individuals who are uninsured or are looking for affordable health insurance to investigate the private health insurance plans available through state marketplaces (to find your state information visit the healthcare.gov website). During open enrollment a person can purchase private health insurance through the marketplace in each state. There may also be financial assistance to help with health care costs available to people with low and moderate incomes. It is also important for people who currently have insurance through the marketplace to look at the plan to determine if it will continue to meet their needs. Individuals who do not take action will be automatically re-enrolled in the current plan. Re-enrollment is also an important opportunity for people to report any changes in income. To learn more, read The Arc’s blog post. Open enrollment ends on December 15, 2018.
On August 1, the Department of Health and Human Services (HHS) released a final rule regarding the sale of short-term limited duration insurance (STLDI). The final rule changes the duration limit from three months to less than 12 months and allows renewal for up to 36 months. STLDI plans are not required to cover the essential health benefits generally required by the Affordable Care Act (ACA), such as rehabilitative and habilitative services, and mental health and substance abuse services. Furthermore, these plans can deny coverage or charge more because of a pre-existing condition, rescind coverage, and impose lifetime and annual limits. The Arc remains concerned that the expansion of these plans will lead to healthier individuals exiting ACA marketplaces and drive up costs for people who need more comprehensive coverage, such as people with disabilities and chronic health conditions. Read The Arc’s statement here.
On June 21, the House Budget Committee approved a Fiscal Year (FY) 2019 Budget Resolution. The budget calls for $6 trillion in cuts over a decade, which include Medicaid per capita caps and block grants, Medicare privatization, and repeal of the Affordable Care Act. The budget resolution contains “reconciliation instructions” that direct eleven committees to come up with at least $302 billion in savings over ten years. This target includes at least $20 billion from the Energy and Commerce Committee and $150 billion from the Ways and Means Committee, which have jurisdiction over Medicare, Medicaid, and the Affordable Care Act. A “reconciliation bill” that outlines how these cuts would be made would require only a simple majority (51) to pass in the Senate. The Senate Budget Committee may write its own FY 2019 Budget Resolution and it is unclear whether the full House will vote on this budget resolution. See The Arc’s statement on the Budget Committee’s passage of the measure here.
On June 7, the Department of Justice announced that it will not defend key provisions of the Affordable Care Act (ACA) in a lawsuit challenging the law’s constitutionality. The lawsuit filed by Texas and 19 other states, argues that since the Tax Cuts and Jobs Act reduced the penalty for not purchasing insurance to $0, it no longer raises revenue, and is therefore no longer constitutional under the tax powers of Congress. Furthermore, they argue that if the court strikes down the individual mandate, the rest of the ACA must also be struck down. The Department of Justice response argues that the individual mandate is unconstitutional but other provisions of the ACA should remain intact. The Administration further asserts that two critical protections for people with pre-existing conditions, guaranteed issue and community rating provisions, are unenforceable. Guaranteed issue is the provision that prevents denial of coverage based on health status and community rating helps keep insurance affordable for people with health conditions. California and sixteen other states have filed a motion to intervene, which would allow them to defend the law. Peter Berns, CEO of The Arc submitted a declaration in support of California’s motion to intervene. Read The Arc’s statement here.
On May 23, the Congressional Budget Office (CBO) released a report titled “Federal Subsidies for Health Insurance Coverage for People under Age 65: 2018-2028.” The report projects premiums for nongroup marketplace plans to increase by an average of 15 percent. The repeal of the individual mandate to have health insurance that was included in the Tax Cuts and Jobs Act of 2017 is a major contributor to the projected increase. The exit of people with lower health care costs from health insurance markets leads to higher premiums for those who remain. Additionally, enactment of a proposed rule expanding the use of time limited plans could lead to further exits and higher premiums.
On April 9, the Centers for Medicare and Medicaid Services (CMS) released a final rule weakening consumer protections in the Affordable Care Act. The final rule increases the amount by which insurers can increase premiums without regulatory approval, from 10% to 15%. Furthermore, it exempts student health plans from this process. The rule also broadens the circumstances when plans are allowed to spend less than 80% of premiums on providing care without being required to reimburse beneficiaries. Additionally, it allows states to narrow the scope of essential health benefits that plans are required to cover. Learn more about the final rule here.