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ACA Court Ruling Will Not Immediately Affect Americans' Coverage

Individual mandate ruled unconstitutional, rest of lawsuit sent back to lower court

gavel with a stethoscope in the background

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En español | The millions of Americans who get their health coverage through the Affordable Care Act (ACA) and benefit from the other protections the law created will not immediately be impacted by Wednesday's court ruling that declared the ACA's individual mandate unconstitutional.

For now, consumers who get their insurance through the ACA marketplaces — including those who signed up during the recently completed open enrollment period — will retain their insurance. And Americans who benefit from other aspects of the law, such as a protection for preexisting conditions, will continue to receive these benefits.

In a 2-1 decision, the 5th Circuit Court of Appeals struck down the requirement that every adult must buy health care coverage or pay a penalty. It sent the rest of the lawsuit back to the lower district court to go through each provision of the ACA to determine whether it can remain in force. Wednesday's split decision on the law delays a final ruling on whether the landmark health law is constitutional overall.

"While today's ruling is disappointing, the important takeaway is that the 5th Circuit's action today doesn't immediately harm anyone's health care benefits,” says Nancy LeaMond, AARP executive vice president and chief advocacy and engagement officer. “The court's decision does, however, leave Americans’ future health benefits in limbo by not resolving this challenge."

The challenge to the ACA was bought by the state of Texas, 19 other states and two individuals. AARP was among the 17 states and advocacy organizations that filed briefs with the court supporting the ACA, arguing that the law is constitutional. The circuit court ruled that because Congress zeroed out the tax penalty for Americans who do not have health insurance, the mandate is unconstitutional. The states defending the ACA said they will appeal the ruling to the U.S. Supreme Court.

"AARP will continue to fight to protect health care for older Americans in Congress and in the courts,” LeaMond says.

The ACA provides benefits and protections that go beyond just the insurance that individuals can buy from the ACA marketplaces. Still intact are such provisions as:

  • Forbidding insurance companies from refusing to cover people with preexisting conditions.
  • Preventing insurers from charging 50- to 64-year-olds more than three times what they charge younger policyholders — what AARP calls an age tax.
  • Allowing states to expand Medicaid to cover people who earn up to 138 percent of poverty.
  • Closing the Medicare coverage gap, known as the “donut hole."
  • Allowing parents to keep their children under the age of 26 on their health insurance policies.
  • Providing free preventive services, such as mammograms, prostate exams and other screenings and routine checkups.
  • Strengthening protections for nursing facility residents.
  • Requiring calorie counts on chain-restaurant menus.

In its decision, the circuit court said that the lower court needed to do a deeper dive into whether some of those protections could stand without the mandate. “It is unclear how provisions like these — which certainly do not directly regulate the health insurance marketplace — were intended to work ‘together’ with the individual mandate,” the circuit court's decision says.

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