ACA Lawsuits Advance During Congressional Recess


Two rules from the Trump Administration issued pursuant to an October 2017 executive order have been challenged in federal district court in Washington, D.C., and those rulings are now being appealed in the D.C. Circuit Court of Appeals. Both rules seek to expand access to health plans that do not comply with the Patient Protection and Affordable Care Act (ACA).

Last month, Judge Richard L. Leon ruled in favor of the Trump Administration and upheld the first rule, which seeks to increase access to short-term plans. On July 29, the short-term plans ruling was appealed to the D.C. Circuit Court of Appeals.

In March, Judge John D. Bates sided against the Trump Administration and invalidated the second rule, which aims to increase access to association health plans (AHPs), claiming that the regulation was a clear attempt to subvert the ACA. In May, the D.C. Circuit Court of Appeals granted a request from the administration for an expedited appeal.

The Trump Administration filed its opening brief on May 31, and it was supported by amicus briefs from Montana and Oklahoma state insurance regulators, 16 Republican state attorneys general and governors, the U.S. Chamber of Commerce, and others. The appellees filed their opening brief on July 15, backed by amicus briefs from former U.S. Department of Labor officials, former state insurance commissioners and regulators, coalitions of consumer advocates, medical professionals, and others. The government filed its reply brief 10 days later, and final briefs are due August 8.

Additionally, several lawsuits have been filed in the Court of Federal Claims regarding unpaid cost-sharing reduction payments (CSRs). At least six insurers have successfully challenged unpaid CSRs, including one class action suit brought by Common Ground Healthcare Cooperative on behalf of over 90 insurers.

There are now four CSR cases pending before the Federal Court: those brought by Montana Health CO-OP, Sanford Health Plan, Community Health Choice, and Maine Community Health Options. On July 30, the court decided to consolidate all four cases, for which oral arguments are expected in early 2020. Some of the cases include unpaid CFRs from 2017, while others include unpaid CFRs from both 2017 and 2018.

Most other CSR lawsuits have been stayed at the district court level pending a decision by the Supreme Court on risk corridors, which will be considered during the next term beginning this October.

Interested in learning more about the status of these cases? Review a recent article by Health Affairs and check back for future updates from Aimed Alliance.


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