On Friday, December 14, a U.S. District Court in Texas ruled that the entire Affordable Care Act is unconstitutional due to its mandate to purchase health insurance.  Congress amended the Act in 2017 to eliminate the tax penalty, but the requirement remained. The court did not issue any injunctions to block enforcement of the 8-year-old law.  

U.S. government officials, including CMS Administrator Seema Verma, indicated that the government would continue business as usual in implementing all provisions of the Affordable Care Act pending appeals and other court action. Ms. Verma said on Twitter “We expect this ruling will be appealed to the Supreme Court. Pending the appeal process, the law remains in place.” 

Were the decision upheld through numerous appeals, many Medicare payment policies would be called into question, including Accountable Care Organizations. Many commentators have already suggested that the decision is unlikely to survive appeal; whatever its resolution, the decision requires no change to Caravan Health operations, or those of its clients, today or in the immediate future.  


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