The ACA - Not Safe Yet

It comes as no surprise that presidential candidate Mitt Romney has promised to "repeal or replace" the Affordable Care Act, despite the fact that he was the architect of the Massachusetts state law upon which the ACA built its foundations.  It is impossible to know if such a promise will come to fruition, especially before the election, but supporters of the law would be foolish not to take such a platform seriously.  After all, the determination and money that drove the challenges to the minimum coverage provision and the Medicaid expansion seem to be, if anything, more energized after the NFIB decision.  Even though the law's challengers failed to strike down the individual mandate, the five more conservative members of the Court adopted the novel constitutional arguments made against both the individual mandate and the Medicaid expansion, leaving plenty of room for future challenges.  And, some of those challenges are already brewing, such as the maintenance of effort fight in Maine, the challenges to coverage of contraception with no copayment, and challenges to providing tax subsidies for private insurance through federally-run exchanges.

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