Published: Mon, June 11, 2018
Medicine | By Earnest Bishop

Trump administration will no longer defend the Affordable Care Act in court

Trump administration will no longer defend the Affordable Care Act in court

The Trump administration has elected not to defend key parts of the Affordable Care Act against a sweeping legal challenge filed by a group of conservative states, marking an unusual departure from the Justice Department's traditional responsibility to safeguard federal law. It said in a brief that the Affordable Care Act's rules barring insurers from denying coverage or charging different rates based on a person's medical history should no longer be enforced because they were created to work alongside the individual mandate.

At issue is a lawsuit filed by 20 Republican state attorneys general on February 26, which charged that Congress' changes to the law in last year's tax bill rendered the entire ACA unconstitutional.

Administration officials at the departments of Health and Human Services and Treasury would not comment, instead pointing to the Justice Department filing, which said other parts of the health law would continue to stand, including its Medicaid expansion covering about 12 million low-income people. Now that Congress has chose to zero out the penalty, as Republicans did a year ago as part of the 2017 tax cut, the pre-existing conditions have to go, too.

Republicans have been trying to dismantle the Affordable Care Act - a centerpiece of President Barack Obama's legacy - since it was enacted in 2010 without any Republican votes. "Their job is to defend federal programs", Bagley says, noting that he has not talked with any of them about the case. Yet he has granted standing to a group of 17 Democratic-led states that filed a brief on Thursday night arguing for the preservation of Obamacare, and will no doubt give them a fair hearing.

The lawsuit argues that with the mandate to purchase insurance still technically in place, but the financial penalty for those who don't abide by it being removed beginning in 2020, Congress' taxing power no longer applies to the provision, leaving it unconstitutional.

Insurers, meanwhile, warned that the administration's actions could rock the individual market and could lead to higher premiums, especially for those battling illnesses.

"The Justice Department has an entrenched, long-standing and bipartisan commitment to defending congressional statutes if reasonable arguments can be made in their defense", he wrote for the Yale Journal on Regulation in March. "The Department will not defend the constitutionality" of the Affordable Care Act. Those two were so closely tied to the insurance-buying mandate that they would not work in the health insurance market without the guaranteed pool of insured people that the mandate was designed to create, Administration lawyers contended.

Supporters of the health care law expressed considerable alarm on Friday.

The U.S. Justice Department says that key parts of the Affordable Care Act are unconstitutional.

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The Democrats further raised concerns that even if the Justice Department's arguments are unsuccessful, the administration's move could still "raise the cost of health care for most Americans, undermine the economy and weaken our democracy for years to come".

The reason so many people could be affected by this decision is because it would apply not just to people with individual insurance policies, "but also [to] people with preexisting conditions who have employer-sponsored coverage".

That's not so surprising considering more than 52 million non-elderly Americans have health conditions that could have rendered them uninsurable prior to Obamacare, a Kaiser Family Foundation analysis found.

The DOJ's decision not to defend the mandate's constitutionality will not prevent the court in Texas v United States from resolving the question, Sessions said.

The 20 states that brought the lawsuit include Texas, Wisconsin, Alabama, Arkansas, Arizona, Florida, Georgia, Indiana, Kansas, Louisiana, Missouri, Nebraska, North Dakota, South Dakota, South Carolina, Tennessee, Utah, Virginia, and Gov. Paul LePage for the State of ME and Gov. Phil Bryant for Mississippi.

Many health care experts disagree with that position. A Justice Department spokeswoman said the lawyers' withdrawal had been a department decision, declining to specify whether the lawyers had personally objected to continuing on the case.

Some Democratic politicians didn't waste much time.

"I urge Congressman MacArthur publicly demands that President Trump defends protections for pre-existing conditions and upholds the ACA immediately, so our premiums and medical bills don't skyrocket even further", Kim said in a statement responding to Thursday's decision. In 2012, the Supreme Court held that the insurance mandate was unconstitutional as a nationwide mandate.

The Texas district court judge, Judge Reed O'Connor, still has to rule on the request Texas and Texas' allies have made for the preliminary injunction.

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