HealthSource RI’s Long-Term Viability Now in Question After Federal Court Ruling

Sunday, December 16, 2018


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Obamacare was the hallmark legislation of his Presidency

RI State officials are putting the best face on the future of HealthSource RI after a federal court judge in Texas struck down Obamacare. In the short-term — the next few months — there should be no effect, but the longer-term implications could be profound.

"If this Texas decision on the [Affordable Care Act] is upheld, it would throw the individual insurance market and the whole health care system into complete chaos," Larry Levitt, a senior vice president of the Kaiser Family Foundation, Tweeted "But, the case still has a long legal road to travel before that's an immediate threat."

Should Rhode Islanders be concerned?

The simple answer is yes. While RI HealthSource and the other health exchanges were created as a result of the Patient Protection and Affordable Care Act or Obamacare, they will not be directly impacted in the short-term, but federal court judge Reed O’Connor’s decision sets the stage for the issue to be arbitrated by a very new Supreme Court.

"Yes, they (Center for Medicare and Medicaid) reached out this morning (Saturday) to express that last night’s decision does not have any immediate impact on the implementation or ongoing operations of the ACA. In addition, CMS Administrator Seema Verma tweeted out the following statement, “The recent federal court decision is still moving through the courts, and the exchanges are still open for business and we will continue with open enrollment. There is no impact to current coverage or coverage in a 2019 plan,” said Zach Sherman, Director of HealthSource RI via an email to GoLocal.

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Zach Sherman, HealthSource RI Director

Healthcare insurance expert Rob Calise of the Hilb Group, a GoLocal contributor, says, "After reviewing the decision it appears that there will be no impact to HealthSourceRI in the short term. The decision by U.S. District Court Judge Reed O'Connor will be appealed to a higher court. For now, it’s business as usual and no need for Rhode Islanders to panic."

"The Affordable Care Act is still in effect and providing people with health insurance. In fact, the deadline to sign up for coverage next year is early Sunday morning, at 3 a.m. ET, so there are still a few hours to sign up," Calise said.

Consumer Reports warns “misunderstandings about the law can dampen enrollment and the latest news is likely to sow more confusion. A recent survey by the Kaiser Family Foundation found that one in four people who are uninsured or buy their own health insurance don’t know when open enrollment ends and only one-third of people know that Congress got rid of the penalty for not having health insurance. 

"I don't know if states have received any communication from Washington. The Texas decision was not issued by the Trump admin - it's a district court in TX, and I'm confident that this will be appealed. This is the last day of open enrollment for 2019, and it's still proceeding (no changes)," said Robert B. Hackey, PhD, who is the  Chair of the Department of Health Policy & Management at Providence College.

“As of December 8th, 4.1 million people signed up for plans sold on the 39 federally-run exchanges. That’s down about 12 percent from the same time last year. Enrollment is lagging for a number of reasons, including the fact that there is no longer a penalty for not buying insurance, and because high premiums make insurance difficult to afford for people who don’t get financial assistance,” writes Consumer Reports.

“The federal government funds premium subsidies which help pay for the health insurance available through HealthSource RI. In 2018, we expect the total value of the subsidies to be nearly $100 million.  HSRI’s operations are not funded by the federal government,” said Sherman. HealthSource receives less than $10 million annually from RI taxpayers.

Sherman confirmed that the future of Obamacare is likely to be in the United States Supreme Court, “Open Enrollment is ongoing and we strongly urge customers to sign up for coverage before the end of year deadline.  While this decision is disappointing, it is not final and we anticipate it will wind its way through the courts, likely ending up in the Supreme Court. Through the ACA we have dropped the uninsured by nearly two thirds and today, over 95% of Rhode Islanders have health insurance.”

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A new Supreme Court will ultimately decide --Neil Gorsuch

A Different Supreme Court

As soon as the decision was rendered on Friday the political spin went into effect.

“The ACA has already survived more than 70 unsuccessful repeal attempts and withstood scrutiny in the Supreme Court,” said a statement from California Attorney General Xavier Becerra. “Today’s misguided ruling will not deter us: our coalition will continue to fight in court for the health and wellbeing of all Americans.”

But, the Supreme Court the affirmed Obamacare is very different today. The landmark case that upheld Obamacare, National Federation of Independent Business v. Sebelius, was decided by the U.S. Supreme Court in 2012 by a vote of 5-4 and since then, President Donald Trump has named two new members of the United States Supreme Court.

Justice Antonia Scalia died and  Anthony Kennedy resigned. The two new members of the court are expected to move the court firmly to the right.

The GOP Obamacare opponents should not count on an automatic overturn.

The Washington, DC, appeals court in 2011 heard an Obamacare challenge and Judge Brett Kavanaugh, then a member of the D.C. Court and now the newest member of the Supreme Court dissented in a vote to affirm the law, but issued statements on both sides of the issue.

Neil Gorsuch, the other Trump appointee to the Court is much more vested in the fate of Obamacare — he is on record as a federal court judge in a case involving the toy store chain Hobby Lobby

According to a Forbes, ”Gorsuch wrote in the concurring opinion that "the ACA’s mandate requires them to violate their religious faith by forcing them to lend an impermissible degree of assistance to conduct their religion teaches to be gravely wrong."


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