After Democrats passed the Affordable Care Act in 2010, conservative lawyers immediately launched multiple legal challenges. The ACA – also known as “Obamacare” – survived all of those challenges, winning over the conservative majority on the Supreme Court.
When Donald Trump took office in 2017, he was backed up by Republican majorities in both houses of Congress. Republicans vowed to repeal the hated health care law. They failed, and the backlash to their efforts helped fuel Democrats’ eventual takeover of the House.
Trump administration officials worked hard behind the scenes to sabotage the law, granting waivers to red states that made it harder for individuals to access Medicaid and other services. The Trump administration dramatically slashed outreach funding, to the point where the state of California now spends more on outreach than the entire United States government.
And yet Obamacare is not just surviving – it’s thriving. Premiums for plans offered on the insurance exchanges are down, and millions of Americans are accessing health insurance. Insurers are no longer abandoning the exchanges.
The question, then, is whether Obamacare, which has survived so many attacks, can do it one more time. Legal experts believe a ruling is set to come down in a lawsuit that, once again, poses an existential threat to Obamacare. And while any ruling in that case will inevitably be appealed to the Supreme Court, another ruling against Obamacare would once again thrust it into the national spotlight.
The State of Obamacare
Open enrollment in the Obamacare exchanges started Friday. When online shoppers visit their state’s exchange, they will find premiums are lower by about four percent. And in a handful of states, those premiums will be lower by double digits – Colorado leads the field with an average premium discount of more than 20 percent.
In addition, after years of high-profile news stories about insurers dropping out of the exchange and leaving counties without health insurance providers, insurers are coming back, and most shoppers will have multiple options.
This is not to say that all is rosy in the world of Obamacare. Many of the plans offered on the exchanges come with debilitatingly high deductibles, and enrollment has dropped while the uninsured rate, which had been falling for years, is inching up. Critics attribute the rise in the uninsured rate to Trump administration sabotage, while Trump officials blame it on the high price of some Obamacare plans.
One Last Legal Threat
But with the threat of legislative repeal off the table for the time being, Obamacare faces yet another legal challenge. As American Legal News has covered in the recent past, federal judge Reed O’Connor struck down Obamacare in a controversial ruling that appalled even conservative legal scholars. The lawsuit, brought by a group of red states, argues that the law is now unconstitutional as a result of the Republican Congress setting the insurance mandate penalty to $0.
That ruling was appealed to the Fifth Circuit Court of Appeals, which heard oral arguments in July. A ruling from the Fifth Circuit is expected any day.
Insurers and officials at the state and federal levels are bracing for that ruling. The court could uphold Judge O’Connor’s ruling and completely strike down the healthcare law. It could strike down certain parts of the law without striking down the whole thing. Or it could completely reverse Judge O’Connor’s earlier ruling.
Regardless, any such ruling would likely be appealed to the Supreme Court. Which means that, once again, the Court would be in a position to issue an extraordinarily important ruling on Obamacare right in the middle of a presidential campaign.