The Individual Mandate Ruling: What Does it Mean for Mass.?

The Fifth Circuit Court of Appeals ruling last Wednesday that the Affordable Care Act's (ACA’s) individual mandate provision is unconstitutional does not invalidate the Massachusetts individual mandate that has been in effect since passage of the state’s historic Chapter 58 health reform law.
The Appeals ruling means that the case goes back to the back to the U.S. District Court in Texas where it originated, and that the judge there – Reed O'Connor – will reconsider what provisions of the ACA should remain intact. O’Connor has opined that the entire ACA should be scrapped.
The court’s ruling relates to the federal tax penalty, or lack of one, associated with the ACA’s individual mandate and is, therefore, not applicable to the Massachusetts mandate. However, if the entire ACA law or other elements are invalidated, Massachusetts would take a massive hit. A Blue Cross Blue Shield Foundation brief shows how overturning the ACA would result in 375,000 Massachusetts residents losing coverage, the state losing $2.4 billion in federal funding, and uncompensated care increasing by $400 million.
Legal observers are predicting that the case that has been bounced back to Texas will eventually end up in the U.S. Supreme Court.