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Home/Legal & Regulatory and Reimbursement/Maryland Sues to Head Off Texas ACA Challenge
Legal & Regulatory and Reimbursement

Maryland Sues to Head Off Texas ACA Challenge

October 3, 2018 2 min read Premium comments

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Maryland Sues to Head Off Texas ACA Challenge
Photo creation by RRY Publications
#affordablecareactSecondary#aca#obamacare

While the rest of the country waits for a Texas judge to make his ruling (https://ryortho.com/2018/09/texas-lawsuit-challenges-aca/) on the constitutionality of the Affordable Care Act (ACA), Maryland decided to take swift action. Maryland filed a separate lawsuit in a different federal court requesting an injunction to require the government to continue to enforce the ACA.

The Patient Protection and Affordable Care Act (ACA), or Obamacare, is the healthcare reform legislation that was passed by the 111th Congress and signed into law by President Barack Obama in March 2010. The ACA requires individuals to carry insurance―otherwise they are subject to a fine.

After the ACA was enacted, the insurance mandate was challenged. The United States Supreme Court upheld the law under the Commerce Clause, reasoning that the insurance mandate could reasonably be read as a tax.

Twenty conservative states filed a lawsuit in Texas, asking U.S. District Judge Reed O’Connor to block the enforcement of the entire ACA. A coalition of liberal states interceded into the suit to defend the ACA. At oral arguments, it became clear that Judge O’Connor may potentially rule for the plaintiff states.

Maryland decided to take action. Maryland Attorney General Brian E. Frosh filed suit in the U.S. District Court for the District of Maryland against the Trump Administration, seeking a declaratory judgment that the ACA is constitutional and that the government must stop taking actions to dismantle it.

Speaking about the lawsuit, Attorney General Frosh stated, “We cannot allow President Trump and Attorney General Sessions to destroy the ACA…Their attempts to sabotage this life-saving law and jeopardize the health of Marylanders who rely on it cannot stand. We are taking action to protect and ensure health care coverage for every Marylander and all Americans.”

Writing for The Incidental Economist, University of Michigan law professor Nicholas Bagley commented, “Depending on how quickly the Maryland case moves, it’s possible we could see dueling injunctions—one ordering the Trump administration to stop enforcing the law, the other ordering it to keep enforcing. That’s an unholy mess just waiting to happen. Now, it may not come to that. My best guess is that the Texas lawsuit will fizzle: any injunction will likely be stayed pending appeal, either by the Fifth Circuit or the Supreme Court, and the case is going nowhere on the merits. The Maryland lawsuit will likely prove unnecessary.”

React:

Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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