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Healthy Indiana Plan not directly impacted by federal appeals court ruling on Obamacare

Healthy Indiana Plan not directly impacted by federal appeals court ruling on Obamacare

HIP logo 2019

The Healthy Indiana Plan (HIP) will continue providing health coverage to some 418,000 Hoosiers after a federal appeals court on Dec. 18 postponed a decision on whether the entire Affordable Care Act, also known as Obamacare, is legally invalid.

In a 98-page ruling, the 5th U.S. Circuit Court of Appeals affirmed part of a Texas federal court ruling that struck down the "individual mandate" in Obamacare as unconstitutional.

But the appeals court also sent the case back to the trial court to determine whether that result necessarily requires all of Obamacare be stricken from the law books — including the Medicaid expansion Indiana adopted as HIP — or whether portions of the 2010 health law separate from the individual mandate can remain in effect.

"This issue involves a challenging legal doctrine applied to an extensive, complex and oft-amended statutory scheme," wrote Judge Jennifer Walker Elrod, who was appointed to the appellate bench by Republican President George W. Bush.

"All together, these observations highlight the need for a careful, granular approach to carrying out the inherently difficult task of severability analysis in the specific context of this case."

It likely will take at least a year before the trial court determines the fate of the remainder of Obamacare.

Any ruling then would be subject to appeal at the 5th Circuit, and potentially the U.S. Supreme Court, pushing a final resolution of the case — and its impact on HIP — several years into the future.

Separately, Congress also could eliminate the underlying basis for the lawsuit by undoing a provision of the 2017 Tax Cuts and Jobs Act that deleted the tax penalty for failing to comply with the individual mandate, an Obamacare requirement that all Americans purchase and maintain health coverage.

The U.S. Supreme Court in 2012 affirmed the constitutionality of the individual mandate and most portions of the health law under Congress' power to tax.

The appeals court, however, said with the tax penalty now zeroed out, the individual mandate is an unconstitutional command by Congress for Americans to purchase a specific product.

Attorney General Curtis Hill Jr., a Republican who joined the lawsuit to strike down all of Obamacare on behalf of Indiana, said Republican President Donald Trump should use this opportunity to keep his pledge "to give the American people the best health care in the world."

"From the beginning, the Affordable Care Act amounted to federal overreach. Congress should never have imposed this one-size-fits-all mandate in the first place," Hill said.

"Choice, freedom and the roles of the individual states must remain part of the health care equation in America."

Meanwhile, state Sen. Karen Tallian, D-Ogden Dunes, a Democratic candidate for Indiana attorney general, condemned Hill for championing a lawsuit funded by taxpayer dollars that still could strip health care from hundreds of thousands of Hoosiers — with no strategy for what happens afterward.

"HIP was the Republican health care plan for Indiana, passed under the (Gov. Mike) Pence administration. Even Gov. (Eric) Holcomb's administration just recently submitted our filings with the federal government to extend that program for several years," Tallian said.

"It is time for the governor and his administration to stand up and tell Curtis Hill no."

Former Evansville Mayor Jonathan Weinzapfel, who also is seeking the Democratic attorney general nomination, similarly blasted Hill for aligning himself "with the extreme partisan politics of Washington politicians to take away health care from thousands of Hoosier families."

"We need an attorney general who's going to advocate for Hoosier families — not fight to take their health care away. We need to stop playing politics when people's lives are at risk," Weinzapfel said.

Notwithstanding Hill's lawsuit, the Holcomb administration is seeking federal approval for a 10-year extension of HIP, which otherwise is due to expire Dec. 31, 2020.


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