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ACA Constitutionality Lawsuit Explained: How It Could (Or Won't) Impact Vermonters

A yellow toy ambulance sits on a white surface.
Zhen Hu
The U.S. Court of Appeals for the Fifth Circuit heard oral arguments this week after a lower court determined the Affordable Care Act is unconstitutional. It's not yet clear what the higher court will decide.

The Affordable Care Act — a.k.a. Obamacare — is making headlines once again as a lawsuit moves through the Fifth U.S. Circuit Court of Appeals, which will decide whether a lower court’s ruling, that the law is unconstitutional,  should be upheld. This begs the question: what does this mean for Vermonters?

What Could Change

Secretary of the Vermont Agency of Human Services, Al Gobeille, outlined in this court document what's at stake if the ACA is indeed determined as unconstitutional. This includes:

  • The state's health exchange, Vermont Health Connect
  • 81.6 percent of the state's health exchange customers who receive federal tax subsidies for health insurance premiums
  • The hundreds of millions of dollars directed through the ACA for the above-mentioned federal subsidies, Medicaid expansion, and the Public Health Fund

"The ACA's impact on Vermont, just as on the nation, is significant and far reaching: from increasing access to health care insurance to ensuring that breastfeeding women are provided adequate break time for nursing and pumping," wrote Vermont's Director of Health Care Reform, Ena Backus, in a statement. "The loss of these funds and subsidies would dramatically impact the ability of Vermonters to access affordable health care coverage. The ACA has also expanded programs that improve access to home and community-based services and has created more robust consumer protections."

What Will Stay

Regardless of whether the ACA remains federal law, Vermont lawmakers recently enshrined several of its provisions during the 2019 legislative session.

Act 63, which Gov. Phil Scott signed in June, aligns state law with federal standards. Among its provisions:

  • Children up to the age of 26 can be covered by their parents' insurance
  • People with pre-existing conditions cannot be excluded by insurers

The law also establishes the individual mandate on a state level, even though the tax reform law passed by U.S. Congress in 2017 repealed that part of the ACA.

Vermont's Stance

Vermont is one of 21 states acting as intervening defendants in the ACA unconstitutionality lawsuit.

The case was originally filed in U.S. District Court for the Northern District of Texas, which agreed with Texas, 19 other states and two individual plaintiffs that the ACA's individual mandate is unconstitutional, and is inseverable from the rest of the law, making the entire ACA unconstitutional. 

U.S. House of Representatives filed a motion to intervene, which was granted by the Fifth Circuit Court. Oral arguments were held there on Tuesday.

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