Dissecting Texas Leaders' Reactions to the Affordable Care Act Lawsuit

Like millions of Americans, CPPP is dismayed by Texas Attorney General Ken Paxton’s attack on the Affordable Care Act and the federal judge's lower court decision announced on Friday. It’s critical for all Texans to remember that the Affordable Care Act is still the law of the land and that all coverage remains in effect while the decision is on appeal.


Governor Abbott’s subsequent statement that, “Texas will be ready with replacement health care insurance that includes coverage for preexisting conditions” is a positive first step. His administration and the current Texas state leadership have never previously proposed policies to substantially reduce Texas’ worst-in-the-nation uninsured rate, and Texans need to remain vigilant to see that leaders keep this promise.

To match the Affordable Care Act's preexisting conditions protections, any replacement policy would need to guarantee affordability, insurance prices that are not based on health status, and comprehensive benefits that can cover all medical needs without gaps.

A meaningful Texas plan to replace the Affordable Care Act would NOT be:

  • A return to a “high risk pool,” or a similar way to separately cover people with pre-existing health conditions. Texas’ old high risk pool covered only 28,000 at its peak, leaving 6 million uninsured. Coverage was completely unaffordable for all but the most well-off, because Texas law required the pool to charged Texans with high-risk pre-existing conditions twice the market rate for coverage.

  • Simply passing a law that lets young adults stay on their parents’ coverage to age 26.

  • Simply requiring insurers to “accept” all applicants, despite preexisting conditions. The Affordable Care Act's preexisting protections include (1) no denials of coverage and no increase in premium prices based on preexisting conditions, (2) paired with sliding-scale subsidies to make the cost of coverage adjust to family income, and (3) comprehensive medical benefits, so Texans' insurance will cover their medical needs.

  • Expanding sales of skimpy limited-benefit short-term plans for people in perfect health, but offering no solution to make comprehensive coverage affordable to the rest of us.

  • Ignoring the need for affordable coverage for low- and moderate-income Texans. Texas benefits from $5 billion a year in federal Affordable Care Act subsidies that bring down the price of coverage.

  • Ignoring Texas’ option to access to another $6 to $10 billion per year in federal funding for Medicaid expansion, to insure our poorest working families.

"The Affordable Care Act remains in place, and we urge Texans to stay tuned as the litigation works its way through the court system," said Ann Beeson, CEO of the Center for Public Policy Priorities. "Should a replacement plan be needed, we will be ready to work with Governor Abbott and policymakers on a plan that makes sense for Texas and does not leave vulnerable patients lacking the coverage they need."

In the meantime, Texas leaders could make a big dent in the uninsured population by accepting federal funds to cover the poorest working families, currently left out of Texas Medicaid, but who are "too poor" to get help through the Affordable Care Act Marketplace.