State Leaders Try again to Take Health Care away from Texans

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Poll after poll shows Texans want lawmakers to focus on improving access to health care; not taking it away. Unfortunately, a lawsuit filed by Texas Attorney General Ken Paxton – Texas v. United States or the Health Care Repeal lawsuit – would do just that by eliminating the entire Affordable Care Act (ACA).

If the Attorney General wins his misguided lawsuit, it would have devastating effects on Texans and people across the country: 20 million Americans would lose their health care coverage, insurance companies would be allowed to once again discriminate against people with pre-existing conditions, and seniors would pay much more for premiums in the Marketplace and drugs in Medicare. The Texas Legislature failed to address health coverage this past session and without the Affordable Care Act, the uninsured rate would skyrocket.

Examples of harm to Texans

  • 1.7 million Texas would lose their health care coverage. The state’s uninsured rate would shoot up by 37 percent.
  • People with a pre-existing condition – like high blood pressure, high cholesterol, diabetes, and asthma — would lose protections. Under the Affordable Care Act, they are assured that they will not be denied coverage, charged more, or face waiting periods due to something in their medical history. Losing these protections would harm the 11.6 million Texans (and 130 million Americans) with a pre-existing condition.
  • Texans would lose the guarantee that their health plan will cover preventive services – like flu shots, mammograms and other cancer screenings, and contraception – at no cost to patients. This would harm 10.3 million Texans, most of whom have job-based insurance.
  • 205,000 young adults in Texas who gained coverage by being able to stay on a parent’s plan to age 26 would lose access.
  • Texans would lose a $4.9 billion/year investment of federal Marketplace subsidies that connect more than 956,000 low- and moderate-income Texans to coverage.
  • Seniors in Texas would have to pay more for prescription drugs because the Medicare “donut hole” would be reopened. In Texas, 333,500 seniors saved money on drugs in 2016, and from 2010-2016, Texans in Medicare saved $1.8 billion.
  • Insurance companies would once again be able to place lifetime caps on your coverage and charge women more than men.
  • Required coverage of “Essential Health Benefits” – like mental health treatment, prescription drugs, and maternity – would end.
  • 759,000 uninsured Texans are in the Coverage Gap, meaning they are left without any affordable insurance options because the one health insurance solution designed for them – federal Medicaid expansion funding for low-wage adults – has so far been rejected by Texas leaders.

How did we get here?

On July 9, 2019, the Fifth Circuit Court of Appeals will hear oral arguments in Texas v. U.S., a lawsuit led by Texas Attorney General Ken Paxton to strike down the entire Affordable Care Act. A three-judge panel of the Fifth Circuit just released its ruling.

Once efforts to repeal the Affordable Care Act in Congress were defeated in 2017, General Paxton, working with other states, switched tactics and sought to invalidate the Affordable Care Act through the courts. They filed suit in February 2018, and Federal District Judge Reed O’Connor ruled for the plaintiffs on December 14, 2018, ruling the entire Affordable Care Act invalid (he stayed his ruling on appeal). In 2018, the Department of Justice declined to defend the ACA provisions that guarantee coverage of pre-existing conditions, but changed its position in March 2019 and is now asking the courts to strike down the entire Affordable Care Act, not just pre-existing condition protections.

CPPP along with Families USA, Community Catalyst, the National Health Law Program, and the Center on Budget and Policy Priorities filed an amicus brief in the case last year.

What Texans and Americans want with respect to health coverage

General Paxton’s lawsuit that would take health coverage away from 1.7 million Texans and end pre-existing condition protections stands in stark contrast with what Texans and Americans want.

Recent Texas polling from the Episcopal Health Foundation shows:

  • 88 percent of Texans say they think health insurance companies should be required to provide coverage for people who have pre-existing health conditions.
  • 85 percent think increasing access to health insurance should be a “top priority” or “important” for the Texas Legislature (57percent say top priority and another 28 percent say important, but not a top priority).
  • 64 percent of Texans support Medicaid expansion.

In addition, polling from the Kaiser Family Foundation (summary of findings from many polls here) shows that strong majorities across political parties support key Affordable Care Act provisions such as pre-existing condition protections; Marketplace subsidies that make coverage more affordable; allowing young adults to stay on a parent’s plan to age 26; preventive health care with no out-of-pocket costs; and coverage of Essential Health Benefits.

Texans want our leaders to improve access to health care, not take it away. Follow CPPP for updates on this litigation.

Stacey Pogue joined the center in 2008. She focuses on health policy issues. Before coming to the center, she did health policy and research work with the Medicaid and CHIP Division of the Health and Human Services Commission and the Texas Department of Insurance. In 2010 and 2011, she was selected to serve as a funded Consumer Representative to the National Association of Insurance Commissioners (NAIC). Pogue earned a Bachelor of Science in Geography, summa cum laude, from Texas A&M University in 1997 and a Master of Public Affairs from the LBJ School of Public Affairs at The University of Texas at Austin in 2005.

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