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February 28, 2018

LePage, filing as individual, joins lawsuit to kill ACA

Courtesy / Matthew Gagnon, Wikimedia Commons)
Courtesy / Matthew Gagnon, Wikimedia Commons)
Gov. Paul LePage joined Republican officials from 19 other states in filing a lawsuit on Monday asking a federal court in Texas to declare the Affordable Care Act as unconstitutional.

Gov. Paul LePage joined Republican officials from 19 other states in filing a lawsuit on Monday asking a federal court in Texas to declare the Affordable Care Act as unconstitutional.

Led by attorneys general in Texas and Wisconsin, the lawsuit filed in the U.S. District Court in the Northern District of Texas claims the repeal of the ACA's individual mandate's tax penalty — which was included in the Tax Cuts and Jobs Act of 2017 signed into law by President Trump in December — renders the entire law unconstitutional.

"Absent the individual mandate, the ACA is an irrational regulatory regime governing an essential market," the complaint states.

Elsewhere in the complaint, LePage and the other plaintiffs assert: "Once the heart of the ACA — the individual mandate — is declared unconstitutional, the remainder of the ACA must also fall."

LePage is joined by one other Republican governor, Phil Bryant of Mississippi, with the remaining plaintiffs being attorneys general of their respective states. The Bangor Daily News reported that LePage signed on as an individual because he can't represent Maine in lawsuits without permission from Attorney General Janet Mills, a Democratic gubernatorial candidate who LePage sued unsuccessfully last year over refusing to represent him in another lawsuit.

The BDN reported that a Mills spokeswoman didn't immediately respond to a request for comment.

How important is the individual mandate?

FierceHealthcare, a health industry newsletter, reported in December that 15 insurance companies surveyed on the question of repealing the individual mandate responded that it would have a negative impact on health insurance markets. Among their reported comments:

It's critical to require people to have insurance, since those who buy coverage only when they need it, and then drop the policy, drive up costs for everyone.

The tax penalty for not getting insurance "does motivate people," with one health plan CEO noting that that his company saw a spike in enrollment when the fine rose from $95 to $695.

Eliminating the mandate is likely to drive up premiums, since healthy people will be the ones most likely to forgo insurance, leaving the risk pool mainly composed of people who "either intend to use it or think they will be using it."

FierceHealthcare also reported in December that the Congressional Budget Office has also estimated that eliminating the mandate would increase the number of uninsured nationwide by 13 million over a decade and hike premiums by about 10%. It added, however, that a separate analysis by Standard & Poor concluded the number of uninsured created by the repeal of the individual mandate would be far less, in the range of 3 million to 5 million.

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