The fate of the Affordable Care Act is again on the line Tuesday, as a federal appeals court in New Orleans takes up a case in which a lower court judge has already ruled the massive health law unconstitutional.
If the lower court ruling is ultimately upheld, the case, Texas v. United States, has the potential to shake the nation’s entire health care system to its core. First, of course, such a decision would immediately affect the estimated 20 million people who get their health coverage through programs created under the law. But ending the ACA would also create chaos in other parts of the health care system that were directly or indirectly changed under the law’s multitude of provisions — including calorie counts on menus, a pathway for approval of generic copies of expensive biologic drugs and, perhaps most important politically, protections for people who have preexisting conditions.
“Billions of dollars of private and public investment — impacting every corner of the American health system — have been made based on the existence of the ACA,” says a friend-of-the-court brief filed by a bipartisan group of economists and other health policy experts to the 5th Circuit Court of Appeals. Upholding the lower court’s ruling, the scholars add, “would upend all of those settled expectations and throw healthcare markets, and 1/5 of the economy, into chaos.”
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