Latest Developments in ACA Court Case + State Updates!

Federal Update:

  • Individual Mandate Data: IRS data shows that the number of people paying individual mandate penalties has been dropping. This is the penalty that you pay if you do not have health insurance coverage. In 2015, 6.67 million taxpayers made individual mandate penalty payments in an average amount of $462. In 2015, 12.7 million people claimed exemptions from having to pay the penalty. In 2016, 4.95 million taxpayers paid an average of $732.
  • Latest Developments in ACA Court Case:Last week the Trump Administration announced that it supports the argument that the ACA is unconstitutional and that the whole law should be struck down.
    • This prompted two Republican attorneys general in Ohio and Montanato file a brief in the case that they don’t think that the entire Affordable Care Act is unconstitutional.
    • A federal judge approved Wisconsin’srequest to withdraw from the lawsuit against the ACA.


State Updates:


  • The Centers for Medicare and Medicaid (CMS) has formally approved Maine’s Medicaid expansion, retroactively to July 2, 2018. This will provide an additional 70,000 people in Maine with health insurance coverage and access to care.


  • Last week, CMS approved Utah’s request for a partial Medicaid expansion, which includes a work requirement.
    • The partial expansion is less than what voters approved by ballot initiative in November, and allows Utah to cap enrollment in the program
    • The work requirements approved in Arkansas and Kentucky were struck down by a federal judge, so it remains to be seen it the work requirement in Utah will stand.
    • The new coverage is slated to take effect on April 1 and the work requirement will take effect in January 2020.


  • In November, voters in Nebraska passed a ballot proposition to expand Medicaid under the ACA, covering an additional 94,000 people. This week, Nebraska officials submitted the initial paperwork to CMS to move forward with Medicaid expansion. However, Nebraska legislators are trying to scale back the expansion by adding a work requirement and tiered access to coverage. And, the expansion will not be available until October 1, 2020.


  • Montana’s Medicaid expansion expires June 30, 2019. Unless extended by the state legislature, 96,000 people in Montana will lose their health insurance coverage. This week, the Montana House approved a bill to continue the program, but with new work requirements, and now it goes to the Senate.


  • Georgia Governor Brian Kemp signed legislation which grants to state authority to apply for a partial Medicaid expansion. This legislation includes work requirements and only applies to people with household incomes up to 100% of the federal poverty level (FPL), rather than the 138% that is allowed under the ACA.


  • The Kansas legislature may go on a month-long break without approving a Medicaid expansion bill that is support by the newly-elected Governor Laura Kelly. The expansion would cover an additional 130,000 Kansans.



  • This week, Texas lawmakers reached an agreement on legislation that would prohibit surprise medical bills for emergency services, as well as out-of-network lab work and imaging. Patients would still be responsible for their in-network payment part of the bills. This legislation would apply to state-regulated insurance plans, including individual, small employer and some local and state government plans, but not to large employer plans regulated by the Labor Department.


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