An Appeals Court Ruling Against The ACA Throws The Future Of Health Care Back Into The Fray

Brennan Linsley/AP Photo
Supporters of the Affordable Care Act, who are also opponents of Colorado’s GOP-led plan to undo Colorado’s state-run insurance exchange, gather for a rally on the state Capitol steps in Denver, Tuesday, Jan. 31, 2017.

Uncertainty over the future of health care coverage in Colorado is back in a big way.

A federal appeals court ruling dealt a blow to the Affordable Care Act, the landmark health law passed under President Barack Obama.

By a 2-1 vote the court ruled that the so-called "individual mandate," the requirement to buy insurance, is invalid. Other parts of the law are being sent back to a lower court to reconsider.

Joe Hanel, with the nonprofit, nonpartisan Colorado Health Institute, worries the impact will be seismic. 

"I'm worried because it's a big part of our health care delivery system is built on the Affordable Care Act, and this would be tearing it down and replacing it with nothing," Hanel said.

He predicts that the case will likely eventually end up in the Supreme Court. While the ruling won't impact 2020 coverage, Hanel said the law did pave the way for many changes in Colorado.

That includes guaranteeing coverage for those with preexisting conditions and a dramatic expansion of Medicaid. In Colorado, roughly 600,000 people gained insurance through the program, which covers low-income Americans and those with disabilities. The law also helped create a health care insurance exchange, Connect for Health Colorado, through which tens of thousands of Coloradans buy insurance on the individual market.

The CEO of the state exchange Kevin Patterson projected a "keep calm and carry on" attitude in a statement:

“I want to reassure our customers that regardless of the ruling by the Fifth Circuit Court of Appeals, the marketplace in Colorado is stable, strong and open for business. The steady pace of 2020 enrollments shows that Coloradans continue to rely on the health insurance coverage and the financial help our marketplace provides," Patterson wrote. "The Affordable Care Act has withstood a variety of challenges since it became law nine years ago and remains unchanged while the case moves through the expected appeals, which will take some time. Colorado has also passed state laws that protect those with pre-existing conditions. You can rest assured that your financial help and plan protections and benefits remain in place.”

The ACA also helped sharply reduce the state’s uninsured rate from more than 14 percent to less than half that. But critics blamed the ACA for failing to rein in high insurance and health care costs and prices.

Reducing health care costs has been one of Gov. Jared Polis' administration's major goals, and the governor said he was disappointed in the ruling in a statement.

“This legal or legislative repeal of the Affordable Care Act without a replacement threatens the progress we’ve made in Colorado on saving people money on health care. Repeal is another attempt to restrict access to quality, affordable health care and would throw thousands of Coloradans living with pre-existing conditions off of their health plan,” Polis said in a statement. “In Colorado, we’re focused on saving people money on health care and delivering results — not more uncertainty. The attorneys general and the White House brought this case forward with no path or replacement to actually prevent costs from going up and protect access to health care for Coloradans.”

Adam Fox, with the consumer group Colorado Consumer Health Initiative, called the case “irresponsible.”

"This court ruling really prolongs the uncertainty around our health coverage system as it has been re-imagined through the Affordable Care Act," Fox said. 

He warned the ruling could eventually strip coverage from those who gained it through the expansion.

Colorado is one of the states defending the Affordable Care Act in the court case.

Colorado’s Democratic Attorney General, Phil Weiser, said “the good news is that the key portions of the Affordable Care Act remain the law of the land.” 

The ACA gave access to health care to 700,000 Coloradans with pre-existing conditions, as well as those under 26 years old who are on their parents’ plans, Weiser said. 

“We must continue to stand up against the federal government’s attacks on health care and the Justice Department’s wrongful decision to challenge — rather than defend — this important law,” Weiser said.

Others worried the decision will set in motion the repeal of the entire law.

“Access to health care is a right and not a privilege,” said Olga Robak of Protect Our Care Colorado, a left-of-center health care advocacy group. She called out Republicans for backing the suit for “sabotage of Americans’ access to health care has left so many people feeling uncertain about their future.”

The ruling also promises that health care will now be an even bigger issue in 2020 political campaigns, both for the presidency and for Colorado Congressional elections.