Tuesday, 14 August, 2018


GOP risks fallout over move on health law | Health care act

GOP risks fallout over move on health law | Health care act GOP risks fallout over move on health law | Health care act
Patty Aguilar | 11 June, 2018, 08:57

In a court filing late Thursday, the Trump administration is specifically urging the Texas federal court to strike down two provisions from the ACA: one that requires insurers to cover people with pre-existing conditions, and the other that prevents insurers from charging individuals a higher premium due to their pre-existing condition.

The decision, announced in a filing in a federal court in Texas, is a rare departure from the Justice Department's practice of defending federal laws in court. 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.

If the judge agrees, "insurers would want to discontinue" health plans that treat healthy and sick customers the same, predicted Larry Levitt, a senior vice president at the Kaiser Family Foundation.

Health care is already a dominant issue in this year's elections, with voters regularly citing it as a leading determinant for how they will vote.

Andy Kim, a former Obama administration staffer, is making coverage of pre-existing conditions and access to affordable health care a key part of his campaign against Rep. Tom MacArthur in Central New Jersey, the author of the Obamacare repeal bill that passed the House but failed in the Senate past year.

The crux of the argument goes back to Chief Justice John G. Roberts Jr.'s 2012 ruling upholding the constitutionality of the individual mandate as a valid use of Congress's taxing power. And the Trump administration has not asserted that the Medicaid expansion made possible by the health care law should be rolled back.

Led by Texas Attorney General Ken Paxton and Wisconsin Attorney General Brad Schimel, the lawsuit said that without the individual mandate, Obamacare in its entirety was unlawful.

The long-shot lawsuit argues that because Republicans repealed the ACA's individual mandate penalty as part of their tax overhaul, all of the remaining law is unconstitutional.

A coalition of 20 US states sued the federal government in February, claiming the law was no longer constitutional after last year's repeal of the penalty that individuals had to pay for not having insurance.

Asked about the Justice Department move, Jesse Hunt, a spokesman for the National Republican Congressional Committee, spoke instead about the Democrats. The individual mandate required most Americans to maintain minimum insurance or to pay a tax penalty.

Crusading against the ACA has been a priority of President Donald Trump since his campaign for the White House.

"So far as I can make out, the Trump administration will continue to enforce the ACA while the litigation progresses", Nicholas Bagley, an assistant professor who specializes in health law at the University of Michigan Law School, wrote Friday in a posting on the Incidental Economist site.

Sen. Susan Collins, R-Maine, who voted against the Republican repeal bills in the Senate past year, also expressed concern about the administration's new push, saying it "creates further uncertainty that could ultimately result in higher costs for millions of Americans and undermine essential protections for people with pre-existing conditions, such as asthma, cancer, heart disease, arthritis and diabetes".

This is a huge deal... the administration's behavior sets a risky precedent about the obligation of this and future presidents to follow their constitutional duty to faithfully execute the laws enacted by Congress....

What do other states say?

Under another provision, the community rating provision, insurers were not allowed to set premiums based on a person's health history. Chris Murphy, D-Conn., said in a statement. "At the worst it could strip away guaranteed coverage for those with pre-existing conditions".

A group of Democratic state attorneys general, lead by California's Xavier Becerra, are riding to the law's defense.

Three career lawyers in the department's civil division withdrew from the case earlier Thursday and did not sign the brief.

Dismantling the ACA could "push people into positions where they have to make decisions on whether they're going to get treatment or whether they're going to eat", said Charlie Quinn, CEO of RECAP, an Orange County nonprofit that provides social services.

The issues in the court case are unlikely to be resolved quickly, but some experts said the added uncertainty could prompt insurers to seek higher premiums in 2019 for health plans sold to individuals.

Because the lawsuit could easily go all the way to the U.S. Supreme Court, a process that could take years, the protections for people with preexisting conditions are likely to stay in place during that period. Ultimately, the issue could be decided by the Supreme Court.

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