September 29, 2020 – Since the death of late Supreme Court Justice Ruth Bader Ginsburg, many have wondered whether the Affordable Care Act is in danger of being overturned, a potential that would be extremely disruptive to the healthcare industry. payers
« I think there are many ways the ACA can be sustained and there are a lot less ways the court can rule that would harm the ACA by overriding the operational provisions of the ACA » Manatt Health partner Michael Kolber told HealthPayerIntelligence
Kolber noted that, so far, the court has maintained traditional views on the subject of severability, which has led to the court overturning the individual warrant but not the entire law.
Manatt Health CEO Joel Ario agrees with his colleague He said the court was unlikely to overturn the affordable care law in its entirety, given the major disruption that this would result in the health system as a whole
Payers have been following this court case closely because of the impacts it could have on health insurance, in particular
“The insurance industry would certainly find this very disruptive, which is why I don’t know of any of the carriers supporting this litigation,” Ario said in the same interview. “Really all of the players in the system who are actually working in the day-to-day health field, there is a unanimous hope that they do not disrupt ACA and that changes to ACA should happen as part of a normal political process , not through the judicial process «
There are many paths the case could take to its conclusion, which depend on the answers to a few key questions Will the decision be a decision of nine judges or is there a possibility of a split decision in four against four? Will the court overturn part of the law and, if so, which part (s)?
In the event the Supreme Court decides to strike down the entire affordable care law, the impacts on the health sector could be extremely disruptive, Ario and Kolber agreed.
The law would be struck down when the warrant is called into question, weeks after the notice was published, however, that doesn’t necessarily mean that anyone who relies on the Affordable Care Act for coverage will instantly lose their health insurance.
“Health insurance is basically renewed as long as you pay your premium,” Kolber said “The protections that were in ACA are all built into the health insurance policies that people have today. can therefore continue to renew them certainly for the rest of the year, as long as they pay their premium «
That said, the question remains whether individuals would be able to pay their premiums If the Affordable Care Act falls, then federal grants to the law would end soon after the Supreme Court’s tenure, unless let Congress intervene
So while states can continue to offer protections against pre-existing conditions, the subsidies would disappear.There would then be a grace period for non-payment of about one to three months If Congress still does not intervene , many Americans would not be able to afford the premium for medical coverage and could lose their health insurance
It would also remove protections for people with pre-existing conditions, allowing insurers to deny coverage or increase rates based on their medical condition This would have serious implications for the 45% of American families who have at least one non-elderly adult with a pre-existing condition
“There are a lot of provisions in the ACA that work together to protect people with pre-existing conditions,” said Ario. “It would not be possible to restore protections for people with pre-existing conditions without entering in a piece of legislation that is much more complex than simply saying: « People with pre-existing diseases are again protected’’
It would be a particularly disruptive time to overturn the law due to the coronavirus pandemic, which has already caused a lot of churn in the health insurance arena Factors such as the next open listing period for the markets of the Affordable Care Act, which begins nine days before the Supreme Court renders its decision, also weigh heavily
If the court does not overrule the law, there are several different legal avenues the court can take, including a decision upholding the constitutionality of the law or a ruling that invalidates one or more parts of the law
In the event the court overturns part of the law, Kolber said the court will likely not need to send the decision back to the district court that initially declared the entire affordable care law unconstitutional.
When the Fifth Circuit Court of Appeal ruled the individual warrant unconstitutional, it returned the decision to the district court to decipher the effects of that decision
However, Kolber noted that this was an odd result, and he didn’t expect the Supreme Court to pursue a similar strategy unless the justices foresee potential impacts requiring further investigation. thorough
A possible case in which the case would be referred to the lower courts would involve a decision of eight judges and the court would be divided into four.If that happens and the decision is sent back to the lower courts, it could take a few years of no more litigation before a final decision is made, Ario explained
« At any time, Congress could change the statute to clarify what it meant. This could either add a small penalty to the term and thereby eliminate the constitutional question, or repeal the term in its entirety, » Kolber noted. / p>
If the Supreme Court’s decision was four-four and the court process could be extended to a few years, then Congress could make such a decision that would end the case
Given the improbability of a rescinded Affordable Care Act, however, the message to current beneficiaries and potential registrants continues to be the same as in previous legal confrontations of the Affordable Care Act. : keep your health care coverage
“The best way to protect yourself is to continue to keep your coverage in place now, and then purchase coverage for the next year,” Ario said “If there’s anyone going to be protected disturbances, it was the people who took these measures «
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