News Article Details

South Abington Twp. man fears he'll lose health care coverage over ACA court challenge

Times-Tribune - 7/10/2019

Jul. 10--Matthew Stefanelli was relieved when the U.S. Supreme Court upheld the constitutionality of the Affordable Care Act in 2012.

The 38-year-old South Abington Twp. man has suffered with asthma since age 5. A self-employed psychotherapist, he was repeatedly denied coverage because of his medical history. The ACA's mandate that insurance companies cover people with preexisting conditions is his lifeline.

The law once again is in jeopardy, however. The 5th Circuit Court of Appeals in New Orleans heard arguments Tuesday on a Texas judge's ruling that declared the ACA unconstitutional. If the decision stands, it could jeopardize the law, resulting in tens of millions of Americans losing coverage.

"We are terrified that we are going to go backward," Stefanelli said in a Tuesday conference call organized by U.S. Sen. Bob Casey of Scranton.

Stefanelli is among 858,000 people in Pennsylvania at risk of losing coverage if the law is struck down, according to an analysis by the Urban Institute, a nonprofit public research group.

At issue is a 2018 federal lawsuit filed by several Republican state attorneys general. The lawsuit, Texas vs. United States, contends the entire health care law was rendered unconstitutional after Congress repealed in 2017 the "individual mandate" that requires most people buy insurance or face a tax penalty.

Casey, a Democrat, is a strong supporter of the ACA. He said he's concerned many citizens don't know about the court case. He joined forces with the Pennsylvania Health Access Network to help bring it to the public's attention.

"The entire law could be declared unconstitutional," Casey said. "Very few Americans know it's happening. ... We have to do whatever we can to sound the alarm about the devastating impact."

Public opinion is not supposed to influence judges, who are duty bound to rule based on legal principles set forth. Casey said he believes judges do consider the impact of their rulings on the public. That's likely what helped sway U.S. Supreme CourtChief Justice John Roberts to cast the deciding vote that upheld the ACA in 2012, he said.

"Some people think courts are deliberative bodies that make decisions in a soundproof room. That is somewhat true," Casey said. "I think the courts also respond to public outcry."

The 5th Circuit Court of Appeals is not expected to rule for several months. It is expected that the case will land before the U.S. Supreme Court once again as the losing side will most assuredly seek a review of the court's ruling.

Stefanelli said he's frustrated by the continuing legal challenges to the law.

"Here we are again in this situation where it is under attack," he said. "Something we thought was over and done with, they can go back on that and we are again at risk."

He said doesn't know what he will do if the law is struck down and Congress does not take action to ensure insurance companies are required to cover people with preexisting conditions.

Before the ACA was passed, Stefanelli said he was able to find one insurance company to cover him. The premium was $650 a month and had a $10,000 deductible.

"It only gave me access to care in emergency situations," he said. "I still had extraordinary copays and out-of-pocket maximums. Most of my medications were not covered at all."

Under the ACA plan he purchased, his premium is $540 a month, but he has far better coverage. His copays for doctor visits are $10 to $20 and he has no deductible.

"Every day is ongoing anxiety given the nature of what is happening politically," Stefanelli said.

Contact the writer:

tbesecker@timesshamrock.com;

570-348-9137;

@tmbeseckerTT on Twitter

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