Court decision on Obamacare may cut health care access for millions

Should the ACA be found entirely unconstitutional, many now covered may be unable to afford health insurance and could lose their access to medical providers.

On July 9, 2019, a three-judge panel of the U.S. Court of Appeals for the Fifth Circuit held oral arguments in the appeal of a case in which the trial judge said that the Affordable Care Act, also referred to as the ACA or Obamacare, is unconstitutional because Congress effectively eliminated the individual mandate, just one provision of the ACA.

In Texas v. Azar, Judge Reed O'Connor reasoned that when Congress reduced the ACA's fine for not having health insurance to a zero amount, this, in effect, repeals the mandate that everyone have health coverage. He took this a step further and concluded that without the individual insurance mandate, the entire Act is unconstitutional.

According to Vox, legal experts of both political persuasions believe that the Fifth Circuit will probably reverse O'Connor's decision. But, then we would have to see if the U.S. Supreme Court decides to hear the case and what it decide. Many people are waiting anxiously because of the potentially devastating effect on millions who may face losing coverage and becoming unable to afford medical diagnosis and treatment for serious injury and illness.

Obamacare losses by the numbers

The New York Times published a comprehensive analysis of the likely negative repercussions of the ACA being struck down in its entirety. The Times estimated that about 21 million people could lose coverage and that many others could see the cost of care increase.

Of the 21 million, about half buy coverage through the Obamacare marketplace (most using generous federal subsidies) and the other half became eligible for Medicaid through its expansion under the ACA. The Times cited the Urban Institute as saying that an additional three million children would also lose Medicaid or the Children's Health Insurance Program, known as CHIP, when their parents lose public coverage.

The authors reasoned that the loss of Medicaid and CHIP would lead to a decline in medical care and, logically, in overall public health, as the Medicaid expansion has increased preventative care as well as access to medication and to mental health treatment. Many health officials are also concerned because the ACA requires coverage for treatment of addiction and without that mandate, many people receiving treatment for opioid abuse because of Obamacare may be at risk.

And, as is widely discussed in the media, a huge concern would be the loss of the requirement that insurance policies cover pre-existing conditions, which The Times says could affect about 133 million with such diagnoses. Even easily treatable diseases or injuries could remain untreated if patients are unable to purchase coverage for pre-existing conditions at all or at an affordable price.

In addition, loss of ACA bans on insurer payment caps could devastate people with catastrophic injury or illness because they would be in essence uncovered after insurance payments would stop when a certain level of cumulative medical cost is reached.

Obamacare even props up Medicare coverage, the loss of which could raise medical costs for the elderly and disabled covered under that government plan.

These potential developments from the loss of the ACA could lead to needless suffering and even deaths.

The attorneys at Kurzban Kurzban Tetzeli and Pratt P.A. represent injured and ill clients in Florida and across the country who are the victims of medical malpractice or harmed by the negligent behavior of others. We are passionate about the wellbeing of our clients, including access to excellent health care, so will watch for the outcome of this case with concern.