Washington – If upheld, a Texas court decision striking down the Affordable Care Act would likely strip thousands of Connecticut residents of HUSKY coverage, eliminate assistance with premium payments and other out-of-pocket expenses for thousands more, and remove adult children from their parents’ insurance policies.

But before any of this comes to pass, the Texas court decision will face a strong legal challenge which could take more than a year to play out.  In the meantime, the Affordable Care Act remains the law of the land.

The Trump administration on Monday said the decision of U.S. District Judge Reed O’Connor that Obamacare is “invalid” is not the final word, and the law remains in place pending the outcome of appeals.

“The recent U.S. District Court decision regarding the Affordable Care Act is not an injunction that halts the enforcement of the law and not a final judgment,” the Department of Health and Human Services said in a statement. “Therefore, HHS will continue administering and enforcing all aspects of the ACA as it had before the court issued its decision.”

O’Connor’s decision is likely to be appealed to the 5th Circuit Court of Appeals, and that court’s decision to the Supreme Court. The lawsuit was brought by 20 Republican attorneys general. After the Trump administration refused to defend the ACA in that lawsuit, attorney’s general from Connecticut and 16 other states with Democratic governors stepped into that role.

Those Democratic attorneys general are now preparing their appeals.

HHS also said Monday “this decision does not require that HHS make any changes to any of the ACA programs it administers or its enforcement of any portion of the ACA at this time.”

White House Press Secretary Sarah Sanders said, “We expect this ruling will be appealed to the Supreme Court. Pending the appeal process, the law remains in place.”

Connecticut’s ACA marketplace, Access Health CT, has expanded its enrollment period for people seeking coverage in 2019. Saturday’s midnight deadline was extended to Jan. 15,  but those who missed Saturday’s deadline won’t have coverage under a new policy until Feb. 1.

About 100,000 Connecticut individuals and families purchase health insurance through Access Health CT. About 75 percent of these enrollees receive federal help with their premiums, and tens of thousands more receive help with co-pays, deductibles and other out-of-pocket expenses.

In addition, the ACA’s expansion of Medicaid, known as HUSKY in Connecticut, opened Medicaid to adults with low incomes who previously were not eligible for that federal health program because they didn’t have a child under age 19 or were not eligible by age or disability.

As of October 2018, 258,817 low-income adults were enrolled in HUSKY D – the “expansion” portion of Medicaid.

Besides putting people with pre-existing medical conditions at risk, the demise of the ACA would also eliminate the ability of parents to insure their children until age 26 and end the ban on annual and lifetime limits.

Critics of the ACA say it resulted in increased premiums for individuals and small businesses who were not eligible for subsidies, and for those who no longer could purchase stripped-down plans.

President Donald Trump on Monday reached out to Democrats to elicit their help with a replacement for the ACA that would keep the health care law’s more popular provisions – such as protections for people with pre-existing conditions who would find it difficult to find affordable individual insurance coverage without the ACA.

Previous attempts to negotiate a new federal health plan have failed, however, and Democrats are not likely to join in the president’s effort to replace the ACA.

“Republicans have never, ever had a plan to replace the Affordable Care Act. They don’t currently have a plan to replace the Affordable Care Act. And they will never have a plan to replace the Affordable Care Act,” said Sen. Chris Murphy, D-Conn. “The only plan that Republicans have is to strip away people’s health care and protections for sick people through any means possible.”

Republicans have railed against Obamacare since its inception. Anger over the law is credited with sweeping the GOP into power during the Obama administration and fueling a two-week government shutdown in 2013. But public opinion about the law has improved in recent years and many Democrats ran in support of the law – and won—in November’s midterm elections.

Democrats, who condemned the Texas ruling, said on Monday that legal threats to the Affordable Care Act with be a central issue in the 2020 presidential elections.

“It’s clear the 2018 elections (were) about health care and the 2020 elections will be about health care,” said Leslie Dach, chairman of Protect Our Care, a liberal group that champions the ACA.

House Democratic Leader Nancy Pelosi, D-Calif., and Senate Minority Leader Charles Schumer said they plan to call for a vote in the next Congress to intervene in the lawsuit on behalf of the ACA and urge for the ruling to be overturned.

The nation’s health insurers also plan to continue their defense of the Affordable Care Act in court.

“The district court’s decision is misguided and wrong,” said America’s Health Insurance Plans in a statement. “This decision denies coverage to more than 100 million Americans, including seniors, veterans, children, people with disabilities, hardworking Americans with low-incomes, young adults on their parents’ plans until age 26, and millions of Americans with pre-existing conditions.”

AHIP also said “this is just the first step in a lengthy legal process,” and that it “will continue to engage as this decision is appealed.”

Ana has written about politics and policy in Washington, D.C.. for Gannett, Thompson Reuters and UPI. She was a special correspondent for the Miami Herald, and a regular contributor to The New York TImes, Advertising Age and several other publications. She has also worked in broadcast journalism, for CNN and several local NPR stations. She is a graduate of the University of Maryland School of Journalism.

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