ELLSWORTH—The future of the Affordable Care Act, commonly known as Obamacare, was thrown into jeopardy Friday hours before open enrollment for 2019 coverage was set to close.
A federal district court judge in Texas ruled that the law was unconstitutional, sowing confusion among patients and advocates.
“It would be very, very unfortunate if this ruling were left to stand,” said Arthur Blank, president and CEO of Mount Desert Island Hospital.
“It would be a seismic impact that would reverberate through the system.”
After the ruling, officials sought to assure patients coverage for those enrolled in 2019 would not be affected. A banner on healthcare.gov read that the “court’s decision does not affect 2019 enrollment or coverage.”
The Texas case was brought in February by 18 Republican attorneys general and two Republican governors, including Maine’s Paul LePage.
In his Dec. 14 decision, George W. Bush-appointee Judge Reed C. O’Connor took aim at one of the key provisions of the act, the individual mandate to purchase insurance.
O’Connor ruled that the entire healthcare law is unconstitutional because Congress effectively eliminated the individual mandate last December, reducing it to zero as part of major tax legislation.
The Supreme Court had previously upheld the law, ruling that the mandate was a tax and that Congress has the power to levy taxes.
The mandate was a “keystone” of the act, wrote O’Connor in his sweeping decision. Without it, wrote the judge, the law no longer passed the constitutional test.
“In some ways, the question before the Court involves the intent of both the 2010 and 2017 Congresses,” O’Connor wrote in his 55-page decision.
“The former enacted the [Affordable Care Act]. The latter sawed off the last leg it stood on.”
“We are confident it will be overturned,” said Blank, of the Dec. 14 decision. California has vowed to appeal, and the case will likely land in the Supreme Court, which has twice upheld the law.
But if the act were to suddenly disappear, said Blank, “You’d have a wide swathe of folks whose healthcare coverage would suddenly be disrupted. It also would cause great confusion in the healthcare system.”
A spokesperson from Northern Light Health, the parent organization of Maine Coast Hospital, also voiced dissatisfaction.
“Northern Light Health joins the American Hospital Association in expressing disappointment and disagreement with the Texas Court decision,” said Kelley Columber in a statement on Tuesday.
Enrollment for coverage was down significantly in 2019, according to preliminary numbers, but around 75,000 Mainers were enrolled through the exchanges in this year.
The Affordable Care Act also provides funding for Medicaid expansion, which Governor-elect Janet Mills has vowed to enact. That expansion is expected to cover an additional 70,000 residents if it goes into effect next year. The future of the expansion would likely be in jeopardy if the act were to be struck down, said Blank.
“Whenever there’s that kind of a disruption,” said Blank, “We have to commit resources to trying to work with our patients and their families to help them understand what’s going on and it really just takes away from our mission.”
On Monday, California and 15 other states asked Judge O’Connor, who did not issue an injunction as part of his ruling, to affirm that the law still stands while the court battle over its constitutionality continues.