Dec. 18, 2019
Contact: Adam Fox, 303-563-9108,
Katie Reinisch, 303-653-1009,


(DENVER, Colo.) – On the last day of health insurance open enrollment for many Americans (Colorado open enrollment ends January 15th), the 5th Circuit Court of Appeals upheld the district court ruling in Texas v. Azar that the Affordable Care Act’s insurance mandate is unconstitutional, but sent the case back to the lower court to analyze if the rest of the law could be left intact. If the district court determines that the mandate cannot be separated from the law, they could find the entire ACA unconstitutional. The 5th Circuit this past summer heard oral arguments from Republican Attorneys General who filed the case to invalidate the ACA and from Democratic Attorneys General, including Colorado Attorney General Phil Weiser, who intervened to defend the ACA. The Trump Administration’s Department of Justice sided with the plaintiffs by refusing to defend the ACA and then filing a brief arguing the entire law should be struck down.

Regardless of the determination of the district court, it will be appealed and almost certainly be stayed, so it won’t affect coverage immediately, so it is important that Coloradans continue to enroll for ACA coverage, as current health insurance options will not be affected while the court case is appealed. Nonetheless, it is clear that the court’s decision threatens to upend the health coverage system and jeopardize the health and financial security of millions of Americans.

Leaders from the Colorado Consumer Health Initiative, Mental Health Colorado and One Colorado responded to the bad news.

“This decision continues the unprecedented threat to health care for millions of consumers in the U.S. and is a direct result of the Trump Administration’s relentless efforts to sabotage the ACA,” said Adam Fox, director of strategic engagement for the Colorado Consumer Health Initiative. “This court case could strip more than 600,000 Coloradans of the health coverage they need, resulting in a 150 percent increase in the uninsured. If this happens, it will throw the insurance market into chaos and leave our state budget in crisis, people’s lives are at stake in this court case.

“It’s ironic that the legal arguments in this case are that the ACA can’t survive without the mandate for coverage, even though that is precisely the current reality. The ACA continues to function and will continue to do so without the coverage mandate. Even so, this case poses an extraordinary risk to the health of Coloradans. Colorado has fully implemented the ACA at the state level and dramatically reduced the number of uninsured, but, the loss of federal funding to support Medicaid expansion and insurance subsidies could result in putting health coverage and care beyond the reach of almost all that have gained access under the law. It also threatens the stability of clinics and rural hospitals and their surrounding communities. The ACA has become fundamental to our health care system, providing millions with high quality, affordable health care that was once out of reach to many.

“We hope the district court will quickly see the reality and realize that the ACA continues to work without the mandate. Otherwise, this irresponsible and callously driven court case will continue to hang over the heads of millions of Americans and the health coverage they rely on.

“Because of the ACA, people can no longer be denied health coverage because of a pre-existing condition, including mental health and substance use,” said Moe Keller, Director of Advocacy for Mental Health Colorado. “If the ACA is struck down, this will be catastrophic for all individuals with mental health concerns. At a time when we need to be providing more mental health services, taking away mental health services would be devastating. This is not the way to move forward with health care in this country.”

“Every Coloradan should have the opportunity to be their healthiest,” said Daniel Ramos, Executive Director of One Colorado. “We have made significant progress in the last nine years to advance health outcomes for lesbian, gay, bisexual, transgender, and queer (LGBTQ) Coloradans, with policy changes like the Affordable Care Act, Medicaid expansion, non-discrimination protections at the Colorado Division of Insurance, and the benefits that come along with the freedom to marry — but the lived health experience of LGBTQ people remains stagnant or has worsened.

Ramos continued, “Despite the progress made, more LGBTQ Coloradans – especially transgender Coloradans – struggle to afford quality and inclusive care, and they often have to travel long distances to find a provider who will take their insurance. Experiences with harassment and discrimination have increased, and fewer people report these experiences to authorities. Behavioral health outcomes – including anxiety, depression, and suicide ideation – have grown worse. We’re at a critical turning point to improve LGBTQ health in the state. This court case threatens to increase the gap for LGBTQ Coloradans accessing quality, affordable, affirming healthcare.”


A Kaiser Family Foundation poll found 76 percent of voters said that it is very important for the protections for pre-existing conditions to remain in place. One in four Americans lives with a pre-existing condition, and millions more are at risk, given the likelihood of developing a chronic health condition at some point in life.

Colorado Consumer Health Initiative is a nonpartisan, nonprofit group that represents 40+ Colorado health organizations with more than 500,000 health care consumers advocating for equitable access to high-quality, affordable health care. In 2018, CCHI received the “Get Wise” Consumer Protection award from the Department of Regulatory Agencies (DORA).

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