Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


TX Judge Strikes Down ACA, Ruling Expected to be Appealed

A federal judge in Texas struck down the Affordable Care Act (ACA) on Friday, one day before the deadline to enroll in coverage for 2019. The case was brought by 20 GOP-led states that sought to overturn the law’s protections for pre-existing conditions. The Trump administration declined to defend the law in court. Judge Reed O’Conner ruled that the law’s individual mandate is unconstitutional, and that the mandate cannot be separated from the rest of the law – therefore, the rest of the law is invalid. He reasoned that the Supreme Court upheld the individual mandate as a tax. When Congress repealed the fine for failing to comply with the mandate, the penalty was no longer a tax and the mandate was therefore unconstitutional. He also characterized the mandate as essential to the rest of the ACA, arguing that Congress effectively invalidated the entire law when it repealed the individual mandate. The ruling is expected to be appealed, during which time the ACA will remain in effect. O’Conner did not issue an injunction to stop federal officials from enforcing the law in the meantime.

Following the ruling, President Trump took to Twitter to urge congressional leaders to pass a new health care law. Congressional leaders from both parties have stressed that the ruling will not impact premiums or plans for 2019 and called for actions to be taken to protect the nation’s insurance markets from disruption. House Democratic Leader Nancy Pelosi (D-Calif.) has promised that the House will act quickly to uphold protections for people with pre-existing conditions and to intervene in the appeals process when Democrats take control of the chamber in the new congressional session. Ways and Means Committee Chairman Kevin Brady (R-Texas) made similar promises, expressing support for affirming ACA provisions that allow children to stay on their parents’ insurance until age 26 and the prohibition against lifetime limits on insurance coverage. Sen. Chuck Grassley (R-Iowa), the next chairman of the Senate Finance Committee, has stated his intent to hold hearings on the ACA next year, with a focus on maintaining insurance coverage should the law be overturned.

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