Salt Lake City • As they gather at a conference in Utah, governors from around the U.S. are starting to think about what they will do if an appeals court upholds a lower court ruling overturning President Obama’s signature health care law.
More than 20 million Americans would be at risk of losing their health insurance if the 5th U.S. Circuit Court of Appeals agrees with a Texas-based federal judge who declared the Affordable Care Act unconstitutional last December because Congress had eliminated an unpopular tax it imposed on people who did not buy insurance.
The final word on striking down law will almost certainly come from the Supreme Court, which has twice upheld the 2010 legislation.
Nevada Gov. Steve Sisolak, a Democrat, signed a bill earlier this year prohibiting health insurers from denying coverage to patients due to pre-existing conditions, a pre-emptive move in case the Affordable Care Act were struck down.
He said this week in Salt Lake City at the summer meeting of the National Governors Association that he would ask his recently created patient protection commission to come up with recommendations for how to ensure patients don't lose coverage if the law is overturned, which would impact about 200,000 people enrolled in Medicaid expansion in Nevada.
"To rip that away from them would be devastating to a lot of families," Sisolak said. "For example, women's health care: You're talking about with ACA being gone potentially mammograms and cancer screenings and reproductive care and an assortment of coverages they currently have."
Nevada is among a coalition of 20 Democratic-leaning states led by California that appealed the lower court ruling and is urging the appeals court to keep the law intact.
Sisolak and other Democratic governors are scheduled to speak about health care issues Thursday afternoon at a news conference.
Arkansas Gov. Asa Hutchinson, a Republican, said states need Congress to be ready to quickly pass a new health care plan if the court overturns Obama's law, since doing so would cut off federal funding for Medicaid expansion.
A court decision in March blocked Arkansas from enforcing work requirements for its Medicaid expansion program, which has generated seemingly annual debate in that state's Legislature about whether to continue the program.
"Congress can't just leave that out there hanging," Hutchinson said.
The 2018 lawsuit that triggered the latest legal battle over the Affordable Care Act was filed by a coalition of 18 Republican-leaning states including Arkansas, Arizona and Utah.
Arizona Gov. Doug Ducey, a Republican, said he wants to see how the court rules before he makes any decisions about how his state would deal with the loss of Medicaid funds but that Arizona has backup funds available.
"They're going to rule how they're going to rule and we'll deal with the outcome," Ducey said. "The best plans are to have dollars available."
It is unknown when the three-judge panel will rule.
The government said in March that 11.4 million people signed up for health care via provisions of the Affordable Care Act during open enrollment season, a dip of about 300,000 from last year.
Utah Gov. Gary Herbert, a Republican, said if the law is overturned, it would provide a perfect opportunity for Congress to try to craft a better program with support from both political parties.
He said his state, which rolled out its partial Medicaid expansion in April, probably will not start working on a contingency plan for people who would lose coverage until the appeals court rules.
“It’s been talked about for so long, people are saying ‘Why worry about it until it happens?’” Herbert said. “I think there’s a little bit more of a lackadaisical thought process going on.”
