Attacks on the ACA
Texas v. US
On Dec. 14, 2018, a federal district judge in Texas issued a decision declaring the “individual mandate” of the Affordable Care Act (ACA) – the individual coverage requirement – unconstitutional due to the Republican tax cut bill that zeroed out the penalties. Even more drastically, the court declared the entire ACA unconstitutional rather than just the provisions it had found unconstitutional. Among other things, this would end the ACA’s protections for people with pre-existing conditions, including disabilities.
The case has been appealed to the Fifth Circuit Court of Appeals. On March 25, 2019, a coalition of more than 20 states, led by California, filed a brief arguing in favor of the constitutionality of the ACA. On April 1, a number of disability organizations, including CPR, filed a brief with the Court describing the importance of the ACA to people with disabilities and asking the court to find the ACA constitutional.
On May 1, 2019, the Department of Justice (DOJ) filed a brief on behalf of the Trump Administration. DOJ for the first time argued that the entire ACA should be struck down, including the protections for people with pre-existing conditions. In the district court, DOJ had argued that the individual mandate to have health insurance coverage was unconstitutional but that the court should “sever” that section of the ACA and uphold the rest of the law. This article provides a good description of DOJ’s brief and what it means.
Oral argument is scheduled in this case for July. This case will likely be decided late this summer, and then head to the Supreme Court this fall. The district court has issued a “stay” on its decision to strike down the ACA during the lawsuit. That means that the ACA remains in effect while the case is litigated through the court system.
Overview of Attack on the Affordable Care Act (ACA)
On January 20, 2017, the same day that he was inaugurated, President Trump issued an Executive Order stating that his Administration would try to repeal the ACA as quickly as possible.
Although Congress was not able to repeal and replace the ACA through the formal law-making process, the President and various agencies in the Executive Branch have taken significant steps to change and undermine different sections of the ACA. All of these attacks have the same effect: they make it more expensive and harder for people with disabilities and other pre-existing conditions to get health care.
What are Pre-Existing Conditions?
The ACA made it illegal for health insurers to discriminate against people based on pre-existing conditions, which includes any health issues that you have before you get that insurance. Before the ACA, an insurance company could deny people or charge them more for coverage if they had any medical condition or disability. As a result, people with disabilities had fewer options for health insurance, and they had to pay more money than people without disabilities for the same services. Under the ACA, health insurers must treat people equally. They are not allowed to deny coverage, impose higher costs, or limit access to services for people with pre-existing conditions. And yet, the current Administration is trying many different ways to bring back this form of discrimination against people with disabilities.
What’s the Effect? Higher Costs for Everyone
When people with fewer health care needs stop buying full coverage, insurance companies need to raise the price of coverage for the people who know they need to access health care services throughout the year. People with pre-existing conditions and people with disabilities end up facing the same problems as before the ACA, where they have fewer choices and more expensive health care. People who buy these limited plans are not much better off, since they have to pay much more for health care services as issues come up that they cannot predict. When they develop chronic conditions, their insurance does not cover the care they need, and they need to pay for these services on their own.
This disconnected, discriminatory, and misleading system hurts everyone, but it is immediately threatening for people with disabilities. Learn about how you can act now to stop these efforts to take health care away from those who need it!
Five Ways the Trump Administration and Republican Leaders Have Sabotaged Health Insurance Enrollment, FamiliesUSA (Dec. 2018)
Health Care Threat Tracker, FamiliesUSA (2017)
Pre-existing Conditions and Medical Underwriting in the Individual Insurance Market Prior to the ACA, Kaiser Family Foundation (12/12/16)
Response to the Federal Government, Consortium for Citizens with Disabilities (7/12/17)
The Trump Administration’s Hidden Attacks on the Affordable Care Act, The Washington Post (1/5/18)
Proposals for Insurance Options that Don’t Comply with ACA Rules: Trade-Offs in Cost and Regulation, Kaiser Family Foundation (4/18/18)
Short-Term Plans Do Not Cover Life-Saving Mental Health and Substance Use Treatment, Families USA (6/19/18)
Protecting Medicaid and the ACA, Consortium for Citizens with Disabilities