Statement: Fifth Circuit rules ACA’s (already unenforceable) individual mandate is unconstitutional; remainder of ACA still law of the land

RALEIGH (December 19, 2019) – Last night’s Fifth Circuit Court of Appeals’ ruling in Texas v. United States strikes down the Affordable Care Act’s individual mandate as unconstitutional, a ruling as unnecessary as it is unsound, as the mandate was made unenforceable in 2018 by Congress.

Rendering an already unenforceable mandate unconstitutional does little harm – whether unenforceable by Congressional repeal or court decision changes nothing, and leaves the remainder of the ACA intact as it has been now for almost two years. However, the majority of the panel of that court were not content to decide the sole issue before them. Instead they went much further, remanding the case to the District Court to determine if other portions of the act are also unconstitutional.

This is a totally destructive and patently unnecessary ruling. It means millions of North Carolinians and tens of millions of Americans with pre-existing health conditions will continue to live in uncertainty as the critical question of whether or not the entire ACA is severable from the individual mandate remains not with Congress – which essentially answered that question in 2018 in the affirmative – but with a district court seemingly intent on eliminating the ACA and substituting its judgement for that of Congress.

For now, nothing changes for patients in our state. Half a million North Carolinians will continue to benefit from coverage through HealthCare.gov; people with pre-existing conditions in our state are still protected; and critical patient protections under the ACA remain intact.

Sadly, in its advocacy before the Fifth Circuit, the Trump Administration urged the court to undermine the ACA, the very law that now protects tens of millions from insurance discrimination and has led to hundreds of thousands of North Carolinians gaining life-saving insurance coverage.

Fortunately, a coalition of 17 state Attorneys General, including North Carolina’s Attorney General Josh Stein, have intervened in the case to defend critical patient protections that are at risk.

Finally, this ruling out of Texas, does not affect our state’s ability to expand Medicaid. We look to the NC General Assembly to finally close the coverage gap and provide lifesaving care for more than 500,000 North Carolinians. We expect the Fifth Circuit’s ruling to be stayed and re-considered eventually by the United States Supreme Court.