Dec 7, 2019 - Health

The return of the ACA wars

Illustration: Sarah Grillo/Axios

The Affordable Care Act is no longer the center of the national political debate, for the first time in nearly a decade. But it could quickly come roaring back to the fore.

What we're watching: A federal appeals court is set to rule any day now on whether the ACA's individual mandate is unconstitutional (yes, that again) — and, if so, how much of the rest of the law would have to fall along with it.

Why it matters: During oral arguments over the summer, the three-judge panel seemed likely to strike down at least some of the ACA.

  • That would put popular policies, like guaranteed coverage for pre-existing conditions, back on the chopping block and thus back at the center of the health care debate.
  • A ruling ultimately striking down the entire law — the outcome the Trump administration is arguing for — would have even bigger ramifications, upending more technical parts of the ACA.
  • The FDA would have to stop approving certain kinds of drugs, for example, and changes to Medicare, including new powers the Trump administration has relied on, would go away.

What's next: The 5th Circuit Court of Appeals could rule any time. If it upholds the health care law (which would be a surprise), there's a good chance that could be the end of all this.

  • But if that court strikes down any part of it, get ready for another big battle at the Supreme Court.

Go deeper

Supreme Court won't fast-track Affordable Care Act case

Photo: Samuel Corum/Getty Images

The Supreme Court said Monday that it won't speed up a lawsuit that aims to strike down the entire Affordable Care Act. The law's defenders had asked the high court to step in earlier than usual, but the justices opted to let the normal appeals process run its course instead.

Why it matters: This unsurprising move all but ensures that the court won't decide the ACA's fate until after the 2020 presidential election. If the justices ultimately do strike down all or part of the health care law, President Trump won't have to answer for the ensuing disruption during a campaign — and it could end up being his successor's mess to clean up.

Go deeper: The ACA legal fight isn't even close to over

Keep ReadingArrowJan 21, 2020

Supreme Court will hear another ACA contraception case

Affordable Care Act supporters hold up signs outside the Supreme Court. Photo: Bill Clark / Contributor

The Supreme Court agreed on Friday to take up yet another case involving the Affordable Care Act's contraception mandate, which requires most employers to cover birth control in their workers' health care plans.

Where it stands: The court has already said that employers must be able to get an exemption from the contraception mandate if they have a religious objection to the policy. Broadly, the question the court is taking up now is whether the Trump administration has been too permissive with those exemptions. The court will likely rule in early summer.

Go deeper: The ACA legal fight isn't even close to over

Keep ReadingArrowJan 17, 2020

The ACA is doing fine without a mandate penalty

Photo: Samuel Corum/Anadolu Agency/Getty Images

The Affordable Care Act’s insurance market has not been materially affected by the elimination of the individual mandate penalty — undercutting a key argument in the lawsuit urging the courts to strike down the health care law.

The big picture: Healthy enrollees have not left the market in droves, premiums have not spiked and there has been no market death spiral.

Go deeperArrowJan 14, 2020 - Health