Here we go again: The Fifth Circuit U.S. Court of Appeals (which covers most Southern States) declared unconstitutional the individual mandate that holds together the Affordable Care Act (ACA, or Obamacare). So once again, we’re stuck having to wait for the U.S. Supreme Court to weigh in on the future of American health care.
But of course, the Supreme Court already did in 2012 and 2016. And in the past almost ten years, Obamacare has made a difference in at least 20 million Americans’ lives… Including mine.
First, an update on my dad
I’m writing this from my dad’s house, hot on the heels of another hospital visit. He’s at a great hospital, a hospital known for its groundbreaking medical research and world-class treatments. As of now, he’s gradually regaining his vision and his mobility.
Yet, right now, we’re waiting for him to move back to the second hospital he was in. And just like last month, he’s in limbo because his insurance provider and HMO network are demanding that he have his heart surgery at an “in-network facility”.
Fortunately, the second hospital happens to have a great cardiovascular medical team and “in-network” status. Unfortunately, so long as this third hospital (which, by the way, also has a great cardiovascular medical team) and the insurance company are squabbling over where he should have his heart surgery, my dad is the one caught in the middle and left in harm’s way.
But wait, it’s not all bad.
As I explained last time, perhaps the #1 reason why my dad has secured all the good health care that he has is the Affordable Care Act mandating such care. My dad has a Medicare Advantage plan, and the ACA now requires that Medicare Advantage provide maximum coverage at minimum cost.
As I explained last time, Republican attack ads claiming “Obamacare steals from Medicare!” are flat-out false. If anything, Obamacare’s changes to Medicare Advantage have benefited patients like my dad. Even now, his Medicare Advantage insurer must justify another move by guaranteeing that such a move won’t jeopardize his life.
Yet if President Donald Trump and top Texas Republicans continue to have their way in federal court, patients like my dad are royally screwed. Hell, I’ll also be royally screwed.
Oh, wait. Maybe it really is that bad.
Since 2017, I’ve obtained health insurance on the ACA exchange. Since June 2019, I’ve been obtaining care and help for my depression, anxiety, and PTSD. And once more with feeling, my dad’s Medicare Advantage plan is required to cover all it does because of the ACA. So really, both of our lives are being decided in federal courts (again).
In March, we first discussed the ramifications of Texas v. United States, the latest and greatest federal lawsuit threatening to blow up the entire Affordable Care Act. If the U.S. Supreme Court ultimately opts to blow up the entire ACA, then everything from the ACA insurance exchanges to protections for patients with pre-existing conditions and stronger protections for patients on Medicare Advantage will be done away with.
Just yesterday, two of the three judges on the Fifth Circuit panel hearing Texas v. U.S. ruled that the ACA’s individual mandate to have health insurance is unconstitutional. They also sent the rest of the case to the trial court to decide whether it’s legal to sever the rest of the ACA from the individual insurance mandate.
If you don’t think health care is all that big of a deal, think again.
What does it mean for you?
1. The ACA is still the low of the land.
2. If nothing changes, the court won’t have made a decision before the election.
3. Who appoints Supreme Court Justices (choice of president) more important than ever. … 8/
— Andy Slavitt (@ASlavitt) December 18, 2019
As we discussed in March, Texas Attorney General Ken Paxton (R) and the Trump administration are arguing that because Congress zeroed out the individual mandate when they passed Trump’s 2017 Tax Law, the entire ACA must be thrown out lock, stock, and barrel. Yet while the two Republican-appointed Fifth Circuit judges gave their fellow Republicans a major victory by trashing the insurance mandate, they punted on everything else by tossing the severability question back to the lower court.
As we discussed in March, it still doesn’t appear likely that five or more Supreme Court Justices will agree to this line of argument that even prominent conservative legal scholars have rejected… And for that matter, Chief Justice John Roberts himself rejected in 2012. The ACA will remain intact pending Supreme Court appeal, but we can only wonder what the hell comes next while we await that Supreme Court decision.
Meanwhile, I continue to worry about my dad… And to a lesser extent, myself. I know we’re just two of 20 million. But then again, I hope our story helps you understand why this is such a big deal for at least 20 million other Americans.