In December, a federal court ruling further weakened the Affordable Care Act by getting rid of the individual mandate that requires most Americans to have health care. The 5th Circuit Court of Appeals kicked the lawsuit back to a lower court to decide whether the entire law is unconstitutional now that there’s no individual mandate in place.
“The risk now is higher that tens of millions of Americans are going to lose the [health care] protections that they have now,” said U.S. Sen. Bob Casey. The Pennsylvania Democrat has been a vocal supporter of the Affordable Care Act, which is often referred to as Obamacare.
If the lower court decides the law is unconstitutional, millions of people across the country who get health insurance through the ACA would lose coverage, and millions more could be denied access to health care due to pre-existing conditions. In Pennsylvania, 1.1 million people stand to lose access to health care if the law is overturned.
“The motive of this lawsuit may have been political, but we cannot forget the costs that will be paid are human ones,” Pennsylvania Insurance Secretary Jessica Altman said in a statement. “No longer would health insurance guarantee access to maternity care, prescription drugs, or mental health and substance use disorder treatment. Those bringing this suit do not have a backup plan, and if their cavalier actions are ultimately successful, the entire health care system could potentially fail and the American people will pay the price.”
“[Because of the court decision] it is now more likely than not that they’ll lose that coverage,” Casey said. “So there's more risk, more of a threat, and more uncertainty.”
Casey said he plans to fight the Trump administration and Republicans in Congress who have worked to dismantle the health care program.
“We’re going to fight them every step of the way,” he said. “We’re not going to sit down and negotiate on these things.”
Many say the lower court may not decide whether the ACA is constitutional until after the 2020 election, effectively taking the threat of loss of health care off the table as a campaign issue. But Casey said he plans to make health care an issue in 2020.
“It’s going to be a big rough fight and I'm ready for it,” he said. “[Republicans] are going to talk about it, because it’s going to be an issue in this upcoming year. It’s an election year, so we’re going to make the choice very clear: Do you want to vote Republican in these Congressional races and for president, or do you want your protections maintained for a pre-existing condition? That’s your choice.”
Democratic groups are already using GOP attacks on the ACA to target Republicans in districts they’re trying to flip next year. U.S. Rep. Mike Kelly (R-16)’s support for the lawsuit was the focus of a Democratic Congressional Campaign Committee (DCCC) email blast in December.
“This ruling is a terrifying reminder that Congressman Kelly will stop at nothing to eliminate the Affordable Care Act and its protections for Pennsylvanians battling pre-existing conditions like cancer, asthma, and diabetes,” said DCCC spokesperson Courtney Rice. “Pennsylvanians see the work Democrats are doing to lower health care costs while Rep. Kelly continues his campaign to leave millions of Americans with lower quality insurance, higher costs, and fewer protection.”
The DCCC also used similar messaging to target Republican Sean Parnell, who is hoping to win Democratic Congressman Conor Lamb's seat next year.
The Texas lawsuit was prompted by the tax bill passed by House Republicans in 2017, which eliminated the penalty people had to pay if they didn’t have health care coverage. In 2012, the U.S. Supreme Court upheld the Affordable Care Act because Congress has the power to impose taxes (that penalty was considered a tax). The Texas lawsuit argued that taking that tax away makes the entire ACA unconstitutional.