Curious what others think will happen if ACA is overturned by SCOTUS

[LARS]

Do you think if SCOTUS rules ACA is unconstitutional there will be chaos immediately or will ACA somehow be phased out?

Will some states simply mimic ACA requirements for insurers in their states?

 

[Aerides]

To allow this thread for discussion, please refrain from partisan politics which, as our recent past shows, result in thread closure every time we open this topic.

Here are 3 threads covering the same question from the past year. Lots of opinions.

https://www.early-retirement.org/fo...nistration-vow-to-eliminating-aca-103735.html

https://www.early-retirement.org/forums/f38/speaking-of-aca-98666.html

https://www.early-retirement.org/forums/f38/aca-at-risk-97040-10.html

 

[njhowie]

Even if SCOTUS comes to the conclusion that it is unconstitutional, it will not be shut down. States are already able to throw their own spin on top of ACA. For example, even though the individual mandate was eliminated, NJ kept it in place (to negotiate lower premiums with the insurers) and still requires everyone be insured. Similar to prior federal guidelines, if you do not have coverage, then you are fined/penalized by the state.

 

[ocean view]

I believe MA had their own marketplace for years before the Fed mandate came to be. Other states that did the same, IMO, won’t be going anywhere.

No idea what happens to states that hitched onto the Federal marketplace.

 

[Dtail]

It is a big deal to me and my brother. Agree with njhowie, but only for certain states.
Not sure if it would go away so quickly with no substitute or already acknowledged no planned substitute in place.

 

[GalaxyBoy]

If the entire ACA were invalidated, wouldn't the subsidies have to go away? And wouldn't the exchanges go away? What would the insurance companies do, dump the policies or start billing the insured for the cost of full freight?

This sort of uncertainty is what kept me on DW's retiree policy, even though it costs more than an exchange policy. If she dumps me off her policy the terms are that I can't get back on.

 

[jim584672]

Everything I have read about the suit says it is flimsy and dubious in logic, I doubt they get rid of anything.

 

[RetireAge50]

I have no idea what will happen but have always thought it was too good to be true and would disappear someday.

Will then pay for my own healthcare/insurance.

 

[Sojourner]

IMHO, the ACA will not be overturned by the Court this term. The five justices who voted to uphold the law in 2012 are still there and very likely will be skeptical of attempts to overturn it. My two cents...

 

[LARS]

Reason I am interested in folks' views is that we are considering moving from a state where the State AG filed in support of ACA to a state where the AG is part of the lawsuit to overturn.

Add if it is overturned (which if I was to bet would be no) I am looking at probably 15 months of exposure until Medicare.

So I am contemplating if this potential issue is even worth putting in my decision tree as a negative for moving?

 

[Dtail]

Reason I am interested in folks' views is that we are considering moving from a state where the State AG filed in support of ACA to a state where the AG is part of the lawsuit to overturn.

Add if it is overturned (which if I was to bet would be no) I am looking at probably 15 months of exposure until Medicare.

So I am contemplating if this potential issue is even worth putting in my decision tree as a negative for moving?

We had the same situation and still moved. DGF is already on Medicare, but I had 7.5 years to go when I moved. Now down to 4 years.
With only 15 months of exposure, I would not consider this aspect as a make or break decision.

 

[LARS]

We had the same situation and still moved. DGF is already on Medicare, but I had 7.5 years to go when I moved. Now down to 4 years.
With only 15 months of exposure, I would not consider this aspect as a make or break decision.

That is where I am leaning. My concern is not paying for insurance over the gap. My principle concern is if ACA gets stricken down then "preexisting condition" wags its ugly head.

And not withstanding have no health issues (take no medicines), I did have emergency gall bladder surgery 18 months ago. No telling how Insurance company might spin that ...

 

[gauss]

That is where I am leaning. My concern is not paying for insurance over the gap. My principle concern is if ACA gets stricken down then "preexisting condition" wags its ugly head.

And not withstanding have no health issues (take no medicines), I did have emergency gall bladder surgery 18 months ago. No telling how Insurance company might spin that ...

IMHO, It is the lack of community ratings on the premiums that is the large issue.

Most of the opposition proposals include "preexisting condition" protections, but they allow the insurance companies to freely price for them (ie medical underwriting).

-gauss

 

[LARS]

IMHO, It is the lack of community ratings on the premiums that is the large issue.

Most of the opposition proposals include "preexisting condition" protections, but they allow the insurance companies to freely price for them (ie medical underwriting).

-gauss

But in the immediate aftermath if ACA is overturned there will not be any protection.

I agree it will most likely follow (as it is very popular), but how quickly?

I guess another question is if ACA gets overturned do Insurance companies have to honor existing terms of policy until new renewal period. If that is the case my exposure drops to two months!

I am no doubt making more of this than is necessary...

 

[SecondCor521]

I think the Justices are well aware of the importance of the issue and will, if they do overturn any aspect of the law, will likely seek to minimize the turmoil on the country, probably by writing as narrow of an opinion as they can.

The useless answer to the question is that if part of the law is determined to be unconstitutional, then the situation will be such that it is as though that portion of the law is not, in fact, law. With a large complicated law that was crafted as an interdependent whole, I think the challenge for the Court will be determining suitable spots for severability if they do decide to strike down part of the law.

Personally I doubt they will invalidate the entire ACA.

I did consider when making my FIRE decision what I would do if the healthcare landscape changed again. I decided there would probably be a way for me to make it work in whatever new / next system we have. So I personally didn't worry about it too much.

 

[pb4uski]

I doubt that SCOTUS will strike down ACA, but if they did my crystal ball sees existing policies remaining in force for the rest of the calendar year, no medical underwriting as long as someone has continuous coverage (no break in coverage for more than 6 months), etc.

The bugaboo is subsidies, though Congress may well adopt something similar prospectively.

Like I say, I high doubt that it will happen so I'm not going to wate any more brain cells on it.

 

[GalaxyBoy]

What I’ve been reading says the earliest oral arguments would be heard is November so I extrapolate from that a decision wouldn’t be likely until months after that.

 

[GenXguy]

If the entire ACA were invalidated, wouldn't the subsidies have to go away? And wouldn't the exchanges go away?

Yes, and not only that, it would eliminate the Medicaid Expansion, which is actually part of the ACA.

Most legal experts think the plaintiffs' argument is weak and that the ACA will stand.

We should hear a decision by about this time in 2021.

 

[Markola]

Yes, and not only that, it would eliminate the Medicaid Expansion, which is actually part of the ACA.

.

That’s my understanding and why this affects well over 100 million Americans, many of whom vote, not “merely” the 20 million + directly on the exchanges.

 

[aaronc879]

It seems to me that it's an all or nothing situation. They either get rid of the ACA completely or not at all. I think not at all. For my personal situation, I hope it stays in place. If it is abolished I would have to go on Medicaid I guess. My income is $15-20K/yr or less if I choose as I am self employed part time. I have chronic pain that leaves me unable to do full time work yet am not disabled enough to get SS disability because I am only 40(41 in August). It would be very bad for me and millions of other lower income/net worth people if it was abolished.

 

[jim584672]

It seems to me that it's an all or nothing situation. They either get rid of the ACA completely or not at all. I think not at all. For my personal situation, I hope it stays in place. If it is abolished I would have to go on Medicaid I guess. My income is $15-20K/yr or less if I choose as I am self employed part time. I have chronic pain that leaves me unable to do full time work yet am not disabled enough to get SS disability because I am only 40(41 in August). It would be very bad for me and millions of other lower income/net worth people if it was abolished.

If the whole thing goes so does the Medicaid expansion. You would need to be disabled and have almost no assets or income to qualify for regular Medicaid.

I don't see them getting rid of the Medicaid expansion even if they agree with the suit (which I doubt). Medicaid is not insurance and the individual mandate / subsidies don't apply to it.

 

[Katsmeow]

Without getting into the specific merits of any political position (and I ask others not to either), what will happen does depend a great deal on legislation. While the case will be argued in the fall I would expect a decision in the spring of 2021 perhaps right before insurers have to submit what plans they plan to offer. I think that is maybe in April? (not sure). Insurers might want to know the decision before submitting. Of course, if the court does away completely with the ACA then that is a moot point for the ACA but then insurers would have to decide what plans they wanted to do on the open market.

I find it hard to believe the court would invalidate the whole law. But, I guess anything is possible. I would except a decision in the spring of 2021 but it could be as late as June.

Which brings up the political position. We don't know what Congress will be like come January 2021. Theoretically, laws could be passed to make the suit moot. Also new federal laws could be passed in response to the Supreme Court decision.

If the entire act was invalidated and no relevant federal laws were passed then it would be up to each state to determine how they would change their laws (if at all). So, for example, states that once had high risk pools might go back to them or might do something else.

 

[daylatedollarshort]

Our current governor (California) ran on a platform to have some form of universal care, so at a minimum I expect California at the state level would not allow pre-existing condition clauses to return. If the ACA does get invalidated and we have to pay more for health care, I'm just glad we have the funds to do so. We retired pre-ACA, which meant we've had some great savings with the ACA tax credits that were not in our original retirement plan.

 

[GTFan]

IMHO, the ACA will not be overturned by the Court this term. The five justices who voted to uphold the law in 2012 are still there and very likely will be skeptical of attempts to overturn it. My two cents...

Led by Roberts who stretched to uphold in 2012, he's not going to reverse course.

Doesn't really matter to me because the guaranteed issue ship has sailed, there will be legislation requiring insurers to cover all comers no matter what happens to the ACA. We're way past that being an issue now.

The timing of all this with COVID going on boggles the mind, frankly. This will be hammered repeatedly even more than it was in 2018.

 

[ShokWaveRider]

Riddle me this one.

Say ACA IS struck down in 2021, hypothetically say in June 2021. It still would be available in the November / December 2020 signup for 2021, and would become active in January 2021.

If struck down, would ACA contracts for 2021 become void and folks left without Healthcare insurance?

Answering my own question, somehow I doubt it.