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On March 25, 2019, the Trump administration’s Justice Department informed the Fifth Circuit court in Texas that it will no longer defend any part of the ACA in a lawsuit that seeks to invalidate the entire law (more about the lawsuit). Prior to this announcement the administration had defended all but a few provisions of the ACA. This is a sharp reversal but in line with President Trump’s desire to repeal the ACA. He was not successful doing so legislatively, even with Republican control of Congress. Now with the House of Representatives controlled by Democrats, the President’s chances of a legislative repeal are non-existent, so he is attempting to reach his goal through the courts.
It is likely that the Texas case, which is now on appeal, will make its way to the Supreme Court sometime in 2020, with a ruling expected in the summer of 2020. If successful, this lawsuit will dramatically change the landscape for healthcare markets, greatly reducing the role of the federal government.
On the opposite end of the spectrum, there is a growing desire by progressive legislators to dramatically increase the role of the federal government in healthcare. “Medicare-for-All” has become the catch-phrase for a wide range of proposals by these legislators. The range is really wide. It includes everything from Senator Bernie Sanders’ Medicare for All Act, which is a draconian single-payer plan, to the relatively modest Medicare at 55 Act authored by Senator Stabenow, which would lower the Medicare-eligible age to 55 from 65.
The Kaiser Family Foundation has developed this “Compare Medicare-for-All and Public Plan Proposals” resource. It provides an easy-to-use method for comparing the key elements of each proposal.
While it is too early to know how the legal and legislative initiatives will play out, one thing is certain, we will be hearing much more about the ACA and these Medicare-for-All proposals in the coming year and as the 2020 election approaches. We’ll do our best to provide sources of information that help you explain our constantly-changing healthcare market to your clients.
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