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Updates on the Constitutionality of the Affordable Care Act (ACA) and its Mandates

The lawsuit against the “unconstitutional” Affordable Care Act (ACA) is expected to take place this fall in the U.S Supreme Court. President Trump's administration wanted to strike down the Act in June 2020 when the individual mandate penalty was eliminated. They argue based on the decision Congress made in 2017 to reduce the individual mandate penalty (i.e., the fine for not having health insurance) to zero. According to the White House, removing this provision invalidates the entire law.

If its other provisions were upheld, this decision would barely cause any changes, but striking the entire ACA down will affect almost everyone in the country, including small business employers and insurance companies. The specific impacts are not yet known, but the American Health Association has joined several other hospital groups in pushing for a reverse in the appeal.

The provisions of the ACA will still remain in effect during the hearing. The ruling is expected to be heard by the Supreme Court in spring or summer of 2021.

Furthermore, in July, the Supreme Court expanded the exemptions to the ACA’s contraceptive mandate. This exemption ensures that the plan sponsors that strongly object to providing contraceptive coverage on the basis of their sincerely held religious beliefs or moral convictions will not be penalized for not including said coverage in the plan benefits.

The ACA requires health plans to cover women’s preventive health services without cost-sharing, including all FDA approved contraceptives. These religious exemptions apply to certain churches, houses of worship and other church affiliated institutions where they can now opt out of choosing anything under the contraceptive coverage.

With a 7:2 ruling, the Supreme Court now gives authority to the Trump administration under the ACA to provide exemptions from the contraceptive mandate for employers with religious and conscientious objections. Therefore, now additional employers may now be able to opt out of providing ACA mandated contraceptive packages. However, insurance carrier requirements and state law mandates may affect an employers options for these benefits.


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