Statement of Bruce Lesley, president of First Focus on Children, regarding the federal district court ruling in Texas v. Azar declaring the Affordable Care Act to be unconstitutional:

Yesterday’s misguided ruling by Texas District Court Judge Reed O’Connor in Texas v. Azar is one in a series of disturbing attempts to undermine and now wholly repeal the Affordable Care Act (ACA), which could potentially harm millions of children and families and our nation’s health care system.

As a country, we have recently seen the number of uninsured children on the rise — a problem fed by the failure of the government to uphold and protect critical systems that ensure coverage for millions. From Congress and President Trump neglecting to renew the Children’s Health Insurance Program (CHIP) until several months after its funding expired, the Administration’s proposed “public charge” rule to strip coverage for all members in an immigrant household (including health care for U.S. citizen children), and repeated attempts to undermine coverage under the ACA and Medicaid, these compounding incidents aim to limit who has access to health care thus leading to worse health outcomes for future generations.

The Texas court could have numerous fatal consequences:

  • The ruling threatens to strip health coverage for more than 15 million people through the ACA exchanges and Medicaid.
  • The lawsuit could also return us to a time when insurance companies could deny health coverage to 52 million children and families with pre-existing conditions and reimpose annual or lifetime limits to care, despite the Trump Administration’s promises to do the opposite.
  • The legal decision could result in kicking children out of coverage they have through the the health plan of their parents from age 19–26 and eliminating health care for former foster youth in that same age group.
  • It could cause drug prices to rise in children’s hospitals and rural hospitals across the country due to the elimination of the ACA’s 340B provisions.
  • And as another example of the far-reaching consequences and havoc this ruling could create, it potentially lowers the federal matching rates for states in CHIP dramatically (a possibly ironic consequence for the states, such Texas and Wisconsin, that filed this suit).

All of this could occur from a poorly reasoned ruling that clearly thwarts the clear intent of Congress to retain each of these critically-important provisions.

Instead of recklessly creating situations where children could have their lives and well-being threatened due to lack of access to affordable care, we should build on what works and promote proactive policies that ensure that every child has all of the health care services they need to grow and thrive.

The next step is clear. Congress, this administration, and the future courts that will hear the appeal of this ruling must commit to do no harm. And second, any and all policies and decisions that impact our nation’s children should take into account the best interest of the child. This ruling tragically and potentially fatally fails our nation’s children and should be overturned.