On Thursday, the United States Court of Appeals for the District of Columbia upheld the constitutionality of the Affordable Care Act (ACA), which is the comprehensive health reform law signed into law by President Obama in March 2010. The 2-1 Court of Appeals decision joins dozens of other lawsuits challenging the ACA that have been dismissed because either they found the law constitutional or because they determined that the plaintiffs lacked standing. Specifically, this decision found that the personal responsibility provision which is the ACA’s requirement that all Americans obtain health coverage or potentially face a tax penalty, was within Congress’s authority. This is a decisive and important victory as the law moves its way along towards the Supreme Court, which is expected to take up the case during this current term.
While thousands of Nebraskans are already benefiting from portions of the ACA that went into effect in September 2010, the most significant reforms in the ACA will go into effect in January 2014. Among these most important reforms include the establishment of health insurance exchanges, which will serve as new marketplaces where individuals can easily obtain coverage that is made affordable through tax credits. Currently, the Nebraska Department of Insurance is recommending that beyond researching and planning, the state should put off efforts to establish an insurance exchange until after the Supreme Court rules on the constitutionality of the ACA. A decision from the Supreme Court will likely be rendered no sooner than June 2012. We agree with the Omaha World Herald’s recent editorial that to delay implementing the ACA this long would be a mistake.
Thursday’s Court of Appeals decision is another reminder that most federal courts have found the ACA to be constitutional. Only one of the lawsuits has resulted in a federal court finding that the entire ACA is unconstitutional. Regardless of the eventual outcome of the legal battles over the ACA’s constitutionality, states have little to lose and much to gain by moving forward with the implementation process. Our health care system is indisputably broken and states have been given a rare opportunity to examine and deliberate about what solutions might work best for each individual state. Delaying this process will not only make it unlikely that Nebraska can meet the timeline for implementing the law, but it also prevents policymakers and citizens from engaging in the kind of debate that will ensure that the law is implemented in the most effective manner possible.