In a court case filed by Texas and 19 other states, the Justice Department said in a brief on Thursday that the requirement for people to have insurance — the individual mandate — was unconstitutional.
If that argument is accepted by the federal court, it could eviscerate major parts of the Affordable Care Act that remain in place.
A definitive court ruling could be months away and appeals of any decision could take many more months, during which the law is likely to stay in effect.
Even health insurers that don’t expect many of their plan members to drop insurance coverage after the individual mandate penalty is zeroed out still may have to raise individual market premiums in 2019 as their payments from the ACA’s risk adjustment program change thanks to the mandate loss.
Buffalo, N.Y.-based insurer Independent Health doesn’t expect a large number of its 5,000 ACA exchange members to drop their coverage when the individual mandate penalty is effectively repealed starting in 2019. Its population skews older and sicker, and most members need their insurance coverage. Its average member is about 49 years old, and about half receive federal premium subsidies.
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Two self-employed Texans, John Nantz and Neill Hurley, have leading roles in the latest legal effort to kill Obamacare.
The men are the named plaintiffs in a lawsuit by 20 states that argues Congress fatally undercut the law when it repealed the individual mandate penalty in tax cut legislation. Nantz and Hurley say the mandate compels them to buy costly insurance that doesn’t fit their needs — even though the financial penalty for not complying is disappearing next year.
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One of the laws creates a statewide individual mandate, which will require all New Jerseyans who don’t have health coverage through a government program like Medicare or their jobs to buy a policy, or pay a fee at tax time.
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Almost no one saw it coming.
In 2012, Chief Justice John Roberts famously ruled the Affordable Care Act’s provision mandating most people purchase health insurance or else pay a fine constitutional on the basis that Congress has the authority to tax individuals, and the so-called Obamacare “fine” is effectively a tax.
As the now-deceased Justice Antonin Scalia pointed out in his dissenting opinion, in classifying the Obamacare penalty as a “tax,” Roberts ignored history, the language of the healthcare law, statements made by the Obama administration and Democrats in Congress, and common sense. (The obvious difference between a fine and a tax is that the purpose of a tax is to raise revenue, not to force people to behave in a particular way.)
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Well, that didn’t last long. Fewer than six months after Congress effectively repealed Obamacare’s individual mandate—and more than six months before that change actually takes effect, in January next year—another liberal group released a plan to reinstate it. The proposal comes as part of the Urban Institute’s recently released “Healthy America” plan.
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There are already more than a dozen reasons people can use to avoid paying the penalty for not having health insurance. Now the federal government has added four more “hardship exemptions”. Under the new rules, people can apply for a hardship exemption that excuses them from having to have health insurance if they:
- Live in an area where there are no marketplace plans.
- Live in an area where there is just one insurer selling marketplace plans.
- Can’t find an affordable marketplace plan that doesn’t cover abortion.
- Experience “personal circumstances” that make it difficult for them to buy a marketplace plan, including not being able to find a plan in their area that gives them access to specialty care they need.
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Connecticut lawmakers are considering two bills that would impose fines on people for choosing not to buy health insurance.
The Connecticut state House Insurance and Real Estate Committee sponsored House Bill 5379 (H.B. 5379), which would require residents who do not purchase health insurance to pay a fine of $10,000 or 9.66 percent of their annual income, whichever is higher.
Connecticut state Rep. Joe Aresimowicz (D-Berlin) sponsored House Bill 5039 (H.B. 5039), which would levy a fine of $500 or 2 percent of annual income on individuals who decide not to buy health insurance.
H.B. 5039 was approved by the Connecticut General Assembly’s Joint Insurance and Real Estate Committee in March and made available for consideration in the full House of Representatives on April 9. The committee also held a March 2 public hearing on H.B. 5379 but did not vote on the bill.
The Connecticut House has not yet scheduled a vote on either bill.
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Murphycare could look a lot like Obamacare.
Lawmakers Thursday sent to Gov. Phil Murphy a bill that will require nearly all New Jerseyans to have health insurance or pay a penalty in a bid to stabilize premiums for consumers in the Obamacare marketplace.
They approved another bill that would set up a reinsurance plan that would partly be paid for by the federal government and cover some of the most expensive health care claims.
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Ohio officials asked the Trump Administration on Friday to formally waive the Affordable Care Act individual mandate that requires residents to have health insurance, making it the first state to make such a waiver request.
Ohio’s Legislature called for the 1332 waiver last summer, and Congress zeroed out the financial penalty for not having coverage in its tax bill in December.
“The (tax) legislation zeroed out the penalty that is associated with the individual mandate … but … did not eliminate the mandate itself,” Ohio Department of Insurance Director Jillian Froment said in a March 30 letter to HHS Secretary Alex Azar. “That is why Ohio is submitting an application to waive [the mandate].”
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