To buy or not to buy: Consumers confused by judge ruling ACA unconstitutional
Insurance shoppers wanting to sign up for plans on the final day of Affordable Care Act enrollment awoke Saturday to confusion, fury and dire reports that the health care law had been declared unconstitutional.
U.S. District Judge Reed O’Connor, sitting on the federal bench in the northern district of Texas, ruled Friday night that because Congress removed the tax penalty that compelled nearly all Americans to carry health coverage last year, the entire law known as Obamacare is invalid.
O’Connor, a Houston native appointed in 2007 by President George W. Bush, sided with Texas Attorney General Ken Paxton who led coalition that sued in February to challenge the viability of the ACA. In his 55-page decision, O’Connor concluded that when Congress “sawed off the last leg” of the health care law by removing the tax penalty, it made the “individual mandate unconstitutional.”
The individual mandate is considered a pillar of the health care law in that it required most everyone to carry health insurance to expand the risk pool. Prior to the law, insurers could charge the chronically ill or those with pre-existing condition much more for coverage or deny them outright as too risky. O’Connor said that without the individual mandate other provisions, including pre-existing condition protection, are “inservable and therefore invalid.”
RELATED: Texas judge rules Affordable Care Act unconstitutional
The ruling, certain to be appealed and likely destined for the U.S. Supreme Court, quickly reverberated across news stations and social media throughout the night, sowing dismay not only among procrastinating consumers who hoped to buy insurance on the final day of enrollment, but also those who already had bought plans.
“Is there even going to be insurance on the marketplace for 2019?” asked one customer calling into the phone bank of Houston insurer Community Health Choice on Saturday.
“Is my plan that I’m enrolled in still effective?” asked another.
“If I enroll now, will this be good in 2019?” still another asked Angela Waltman, vice president of business development and call center operations for the regional insurance company that sells plans on the federal exchange.
“These are just a few people who called,” she said as her shift ended. “I worry about the tens of thousands of people who didn’t and might be confused or already made the decision not to enroll because they think there is no more insurance. And after today, it will be too late.”
Enrollment for individual and family plans on the federal exchange for 2019 closed at 11:59 p.m. Saturday. For the second year the sign-up period was cut in half to 45 days, down from 90 days before 2017.
Waltman and others at the Community Health Choice said that call volume this year was down roughly 20 percent from last year. Overall enrollment has lagged both in Texas and across the rest of the country.
As of Dec. 8, enrollment was down about 11 percent nationwide from last year and about 6 percent across Texas, according to the latest figures available from the federal Centers for Medicaid and Medicare Services.
Insurers and health care advocates had counted on the traditional spike in number of sign-ups that tend to come in the final days.
RELATED: ACA enrollment closes amid fears that Texas will see big declines
That is why some saw the timing of the ruling questionable as the last day is usually the busiest.
“Cynical me would say it was timed intentionally,” said Katy Caldwell, executive director of Legacy Community Health, the largest network of health centers in Texas. She, too, is worried about the long-term effect if the ruling stands.
Already Texas leads the nation in the number of uninsured. Millions of people across the country have gained access to coverage through the health care law, either through individual plans bought on the exchanges or through Medicaid expansion. Texas is one of 14 states that did not expand Medicaid.
Still, some are pleased with the ruling.
Not long after the news broke Friday night, President Donald Trump praised the decision: “As I predicted all along, Obamacare has been struck down as an UNCONSTITUTIONAL disaster! Now Congress must pass a STRONG law that provides GREAT healthcare and protects pre-existing conditions. Mitch and Nancy, get it done!”
He also tweeted that the ruling was “Great news for America!”
“Our lawsuit seeks to effectively repeal Obamacare, which will give President Trump and Congress the opportunity to replace the failed social experiment with a plan that ensures Texans and all Americans will again have greater choice about what health coverage they need and who will be their doctor,” Paxton said in a statement Friday night.
As the rhetoric flew, supporters of the law switched into damage-control mode, making clear that the ACA was still the law of the land and that nothing had changed - at least not yet.
“Enrollment for health insurance plans will continue without interruption” Austin-based Foundation Communities enrollment center said in a press release sent at 10 p.m. Friday. “If you need insurance come see us.”
RELATED: Study: Pre-existing condition protection in limbo for 102 million in U.S.
Ken Janda, CEO of Community Health Choice, posted a message on Facebook at 5:45 a.m. Saturday: “Misguided and bad decision by Ft. Worth judge announced last night does not change anything for now. Sign up today!”
“I’m very confused. And concerned,” said Houston teacher Dean Lowry on Saturday after trying to make sense of the news.
“I have two of pre-existing conditions that they like to talk about,” he said of his ulcerative colitis and slow-progressing prostate cancer. Although he is insured, he worries about future premium increases that would make it unaffordable if the pre-existing conditions vanishes. “I don’t know what to think tonight. What is my future going to be?”