Sen. Casey derides 'obscene lawsuit' to gut Affordable Care Act; patient advocates lament limbo

U.S. Sen. Bob Casey said Wednesday night he’s concerned about the future of the Affordable Care Act as a lawsuit backed by the Trump administration advances that threatens to nullify the sweeping federal health care law.

“The GOP’s hopes to destroy the ACA live another day,” Casey, D-Scranton, said in a statement. “This is health care sabotage at its worst.”

On a 2-1 vote, a panel of the 5th U.S. Circuit Court of Appeals in New Orleans threw out as unconstitutional the law’s requirement that Americans must obtain insurance coverage. The finding stems from the 2017 federal tax bill reducing the punitive tax for not doing so to $0.

The Texas v. United States ruling does not affect 2020 insurance coverage for ACA plans set to take effect Jan. 1. The deadline to sign up was 3 a.m. Wednesday.

But the decision leaves a critical question unanswered: Can the broader health care law stand without the “individual mandate” rule?

The appeals court “punted” the case back to a lower court to decide its fate, Casey said.

The case ultimately could go before the Supreme Court.

Advocates worry about losing patient protections

Patient advocacy groups lamented the ruling as a potential risk to health care access, affordability and fairness.

More than 1 million Pennsylvanians use health insurance obtained through the ACA marketplace and the expansion of Medicaid in recent years, according to the Pennsylvania Health Access Network. About 80% of people who sign up for ACA plans qualify for subsidies to offset their costs.

“This decision makes it clear that the Affordable Care Act is still under threat,” PHAN Executive Director Antoinette Kraus said, “and while it is, Pennsylvanians will continue to worry that their coverage is at risk.”

Kraus said even a partial overturn of the law could be “catastrophic,” particularly for vulnerable populations guaranteed protections for the first time under the ACA, or for people who previously hadn’t been able to afford coverage.

Among protections the law provided, most of which historically have received bipartisan support as stand-alone elements: prohibiting insurers from charging more for people with pre-existing medical conditions; banning lifetime coverage limits; ensuring access to mental health treatment; and allowing children who want to stay on their parents’ plans until age 26.

Sen. Toomey: GOP will protect pre-existing conditions

Casey accused the Trump administration and GOP leaders of using the courts, Congress and regulations to gut the 2010 health care law “with no plan whatsoever” to replace it. He urged them to drop their support for the lawsuit, “get serious and work with Democrats to build upon” the existing law enacted under the Obama administration in 2010.

Lehigh Valley Republican Sen. Pat Toomey previously has balked at the notion that any member of the GOP is against helping people with prior or chronic conditions retain affordable coverage. He has declined to comment specifically on the lawsuit while it’s playing out, citing policy not to comment on active litigation.

In the meantime, Kraus called on state lawmakers to be proactive and prepare for the potential fallout if the lawsuit prevails, such as by passing state legislation that bans insurers from discriminating against patients with prior medical issues.

An estimated more than 130 million Americans have pre-existing medical conditions, including more than 5.3 million in Pennsylvania, federal data show.