Gov. Beshear, Coalition of States Win U.S. Supreme Court Case Protecting Coverage for Kentuckians with Pre-Existing Conditions

As Attorney General and Governor, Beshear fought to protect essential health care coverage

(File Photo)

FRANKFORT, Ky. (June 17, 2021) – Today, Gov. Andy Beshear and a coalition of states won a U.S. Supreme Court case, California v. Texas, that upholds the Affordable Care Act (ACA), protecting health care coverage for 1.8 million Kentuckians and millions more Americans with pre-existing medical conditions.

Gov. Beshear, who believes health care is a basic human right and who has prioritized access to quality care, first intervened to join the case and defend the ACA in April 2018 as attorney general. In 2020, the Governor joined California Attorney General Xavier Becerra to co-lead the appeal to the U.S. Supreme Court. 

“I am so honored to lead Kentucky’s efforts to preserve access to affordable health care for nearly 1.8 million Kentuckians – and 133 million Americans, including 17 million children – with pre-existing medical conditions, like cancer and pregnancy, and chronic medical conditions, like heart disease, diabetes and asthma,” Gov. Beshear said. “Today is a great day for our Kentucky families and our health care systems. Now those with pre-existing conditions don’t have to worry about being denied coverage; our women and seniors won’t be forced to pay more; and our health care systems will remain strong and ready to care of all our Kentucky families.”

Gov. Beshear said there are at least 10 ways Kentuckians would have been harmed if the case was not overturned, including: expanded Medicaid would have been eliminated; children under the age of 26 would not have been able to remain on their parents’ insurance; seniors would have had to pay more for prescription drugs; and guaranteed pregnancy coverage would have been eliminated. There were also ramifications in the fight against the opioid epidemic and protection from lifetime insurance limits.

Kentucky has reduced its uninsured rate by more than half, with 683,392 Kentucky residents gaining access to health care coverage because of the Affordable Care Act, according to the U.S. Department of Health & Human Services. The commonwealth's uninsured rate fell from 14.3 percent in 2013 to 6.4 percent as of 2019.

Today’s 7-2 decision reversed the Fifth Circuit Court of Appeals’ decision that found the plaintiffs had standing and that would have invalidated the ACA and erased health care for tens of millions of Americans. The lawsuit argued that Congress rendered the ACA’s individual mandate unconstitutional by reducing the tax penalty to $0 and the rest of the ACA should be held invalid because of that change.

At the time Gov. Beshear brought Kentucky into the lawsuit, Kentucky stood to lose nearly $49.7 billion in federal funding for its expanded Medicaid and subsidies for those on the individual market.

The U.S. Supreme Court held that the states and individuals who brought the lawsuit lacked standing and ordered that the lower court dismiss the case.

The coalition joining Gov. Beshear included attorneys general of California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Massachusetts, Michigan, Minnesota (by and through its Department of Commerce), Nevada, New Jersey, New York, North Carolina, Oregon, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia.

The Texas v. U.S. case began in late February 2018, when the plaintiffs, two individuals along with 18 states led by Texas, filed a lawsuit challenging one provision of the ACA: the requirement that individuals maintain health insurance or face a zero-dollar tax. The plaintiffs argued that this change made the minimum coverage provision unconstitutional and that the rest of the ACA could not be “severed” from that one provision, so the entire act must be struck down. Gov. Beshear and the coalition of states moved to intervene in the case on April 9, 2018.

On December 14, 2018, a Northern District of Texas judge issued his decision agreeing with the plaintiffs.

In response, the coalition of attorneys general filed a motion to stay the effect of that decision and to expedite resolution of the case. The district court granted that motion on December 30, 2018. On January 3, 2019, the coalition of attorneys general continued their legal defense and appealed to the Fifth Circuit Court of Appeals. The Fifth Circuit upheld the district court’s decision on December 18, 2019, and Gov. Beshear and the coalition of states sought the Supreme Court’s review on January 3, 2020.