Statement of ACAP CEO Margaret A. Murray on Fifth Circuit Ruling in Texas v. United States

FOR IMMEDIATE RELEASE: December 18, 2019
FOR MORE INFORMATION:  Jeff Van Ness, (202) 204-7515;


WASHINGTON—ACAP Chief Executive Officer Margaret A. Murray today issued the following statement on the recent ruling in the matter of Texas vs. United States, in which the Fifth Circuit Court largely upheld a lower court’s decision finding the individual mandate of the Affordable Care Act to be unconstitutional, and remanded the case back to the lower court to determine which provisions should be deemed unconstitutional:  

This ruling injects uncertainty and chaos in the health care system. It will especially wreak havoc upon the lives of many who depend on subsidized Marketplace coverage or Medicaid expansion. 

Much of this opinion seems to derive from the zeroing-out of the individual mandate penalty and whether a tax of zero is a tax at all. This strikes us as an academic distinction.  

But the possible consequences of this decision are far from academic.  

It could stop Federal funding for Medicaid expansion and throw thousands off the insurance rolls. It could gut consumer protections in the Marketplace and remove important consumer protections against discrimination on the basis of pre-existing conditions, rescissions of coverageand lifetime coverage capsIt could bring back the Part D ‘donut hole’ for seniors, and throw kids between ages 18 and 26 off their parents’ insurance plans. 

The Fifth Circuit’s decision to remand the question of severability to the district court will only create further disarray 

But we’ve seen this before in the repeal and replace debate: repeal seems easy, until one considers its consequences.  So it’s unsurprising that the authors of the Fifth Circuit majority opinion have opted, in considering the real-world consequences of their decision, to punt.  

“But this decision is not an academic abstraction—it has real-world consequences. The lives of our fellow Americans are at stake. And they deserve better.” 

About ACAP
ACAP represents 70 Safety Net Health Plans, which collectively serve more than 20 million people. ACAP-member Safety Net Health Plans and partners serve their communities through Medicaid, Medicare, the Children’s Health Insurance Program (CHIP), and other public health programs. For more information, visit 

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