The following is a statement by James Firman, President and CEO of the National Council on Aging (NCOA), regarding the December 14, 2018, decision by the Federal District Court in Fort Worth, TX, in a lawsuit brought by Republican attorneys general, ruling that the repeal of the Affordable Care Act (ACA) individual mandate in last year’s Republican tax bill rendered the entire ACA unconstitutional: “This court’s decision, if allowed to stand, will have far-reaching and devastating impacts on the health and well-being of nearly all Americans. It jeopardizes health insurance coverage for millions of Americans with pre-existing conditions, as well as Medicaid health coverage for low-income Americans, Medicare prescription drug and preventive services coverage for seniors and people with disabilities, and protections for families with employer-based health insurance. In our view, the decision is wrong and must be overturned. “Coverage for people with pre-existing conditions is a major concern for the pre-Medicare population. Adults aged 55-65 are more likely than younger people to have chronic and other health conditions that, before the ACA, made it extremely difficult for them to get health insurance. These protections are also particularly important for people of all ages with disabilities. If the ACA is repealed, millions of middle-aged Americans will not receive adequate treatment for chronic diseases at earlier stages, which will eventually contribute to much higher overall costs when they eventually enroll in Medicare. “Legal scholars who have reviewed the decision agree that tying the repeal of the individual mandate to unrelated Medicare and Medicaid provisions in the law is unlikely to be upheld upon appeal. Nonetheless, we cannot predict how future courts will rule and believe it is important to understand the potential implications for older Americans. The ACA includes provisions that:

• Strengthen the Medicare Part A Trust Fund by eight years
• Close the Medicare prescription drug donut hole, or coverage gap
• Improve access to Medicaid home and community-based services
• Protect 55- to 64-year-old purchasers of individual market plans from significantly higher monthly premiums
• Provide Medicare coverage for certain preventive services, as well as an annual wellness visit, with no co-payments
• Provide funding for falls prevention and chronic disease self-management services

“The decision also would overturn the ACA Medicaid expansion, which has provided health coverage for millions of low-income Americans, including an estimated 2 million adults aged 50-65. “The Texas court’s opinion has no immediate impact on the broad range of health improvements and services that the ACA covers, but the decision will be appealed and the U.S. Supreme Court may rule at some point on these critical issues. We also expect that Congress will take steps to clarify that these critical health protections and services will remain in place and will not be taken away from the tens of millions in need. NCOA will continue to support efforts to protect and strengthen Medicare, Medicaid, and the Affordable Care Act for all Americans.”