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By: Matt Ingold

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December 17th, 2018

ATTENTION EMPLOYERS: ACA Took a Severe Blow in the Courts, but What Does it Mean for 2019?

Healthcare Compliance

On December 14, 2018 a federal judge in Texas ruled that because the individual mandate (which penalized individuals for failing to have health insurance) would no longer be in effect in 2019, that the “entire Affordable Care Act (ACA) is invalid. They argued that the individual mandate would no longer be a valid tax since the penalty had been reduced to zero, and the entirety of the ACA was unconstitutional. 

Does this mean that the Employer Mandate is going away in 2019?

Definitely not! Employers are still required to adhere to the requirements of the employer mandate and offer affordable coverage to at least 95% of their full time employees, or those employees that have worked on average over 30 hours a week.

The big change on the horizon is the removal of the individual mandate—come January 1, 2019, individuals will no longer be penalized for failure to obtain a minimum level of health insurance. In December of 2017, after failing to repeal and replace the ACA, Congress settled for a reduction of the individual mandate penalty to $0 as part of last year’s tax reform bill.

How does this affect premiums in 2019?

While silver plan premiums have stayed relatively steady, and in some cases have declined, for 2019, research suggests that rates would have declined even further had the individual mandate remained in effect—understandable, it’s likely the healthiest population that will forgo coverage in 2019.

While the ruling in Texas is expected to be repealed and eventually reach the Supreme Court, a final ruling won’t be expected until then.

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About Matt Ingold

Matt serves as Benetech's Director of Business Development. He helps employers reduce the cost of personnel management, and discover where improved talent management can give their business a competitive advantage.

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