Health economics expert: ACA ruling brings uncertainty to healthcare

As Americans hurry to meet today’s deadline to sign up for health insurance through the Affordable Care Act, a ruling by a federal judge in Texas yesterday held the Affordable Care Act unconstitutional.

Wake Forest economics professor Christina Marsh Dalton, an expert on health economics, health care markets, public and private insurance, and the economics of public health policy is available to comment.

The ruling hinges on the fact that the individual mandate no longer has a tax penalty and therefore no bite.  There is a requirement to buy insurance, but no actual enforcement. The reason the judge is claiming this affects the entire legislation is that the individual mandate was cited as a keystone to the whole plan, says Dalton.

“Multiple parts of the ACA, such as disallowing pricing on pre-existing conditions, make insurance markets much more attractive to people in poor health,” says Dalton. “Without healthy people also in the pool to balance out costs, insurance markets won’t be able to maintain prices that are affordable for many consumers. The only way that the benefits to consumers that were legislated by ACA can be sustained is if all consumers, including the healthy ones, are forced into the system. Many conditions of the ACA were built in with this assumption of full participation. Without credible enforcement of the individual mandate, the judge found that the other pieces of the ACA cannot stand.”

Dalton is available today for broadcast, email or phone interviews.