AHIP, Others React to DOJ Move Against ACA in Texas

Desiree Steele
June 11, 2018

The Justice Department lawyers representing Trump's U.S. Department of Health and Human Services and Trump's Internal Revenue Services have asked the court to narrow the scope of the suit, and then to grant a ruling in favor of Texas and its allies on the narrower version of the suit.

That would immediately change if Judge Reed O'Connor of the U.S. District Court for the Northern District of Texas agrees with the Justice Department argument that the mandates including protections for people with preexisting conditions will become unconstitutional in January, when new tax rules end existing penalties for people who flout the law's requirement to carry health insurance. Jost wrote that the development puts health insurers in a quandry, since they are now setting rates for the individual market in 2019.

The popularity of those provisions made repeal politically unsafe, so Republicans chose to leave the popular parts in place and try to repeal only the unpopular parts. "We could not find partners in the Senate who were willing to look at anything", Mr. Burgess said. That ruling hinged on the reasoning that, while the government "does not have the power to order people to buy health insurance", as Chief Justice John Roberts wrote for the majority, it "does have the power to impose a tax on those without health insurance".

The states argued that without the tax penalty that the Supreme Court used as a basis for upholding the legislation, the individual mandate is unconstitutional and is not severable from the Act in its entirety.

"Zeroing out the individual mandate penalty should not result in striking important consumer protections", America's Health Insurance Plans said in a statement. 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.

But the administration disagrees with that position. "Instead, we should focus on advancing proven solutions that ensure affordability for all consumers". On Friday, Democratic members of the House of Representatives were furious.

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".

"They're in charge of everything, right?"

"I concur in the Department's prior determination", Sessions said. Some legal experts say the suit is weak, since it turns on the idea that if one part of a law is invalid, the whole thing is invalid, without recognizing that the Congress passed the law and is free to alter it while leaving the rest in place.

The fresh potential that the courts could deliver a significant blow to the ACA arises after a years-long perseverance by Republicans to repeal much of the sprawling 2010 statute ended in failure a year ago, leading GOP attorneys general, governors and the Trump administration to turn to the courts and administrative actions to undermine the law.

"I've long held a position that the federal government should get completely out of the health insurance business", he said. For instance, in 2012 the Obama Justice Department said it would not defend the Defense of Marriage Act, which legally defined marriage as a union between a man and a woman for federal purposes. Now that Congress has made a decision to zero out the penalty, as Republicans did past year as part of the 2017 tax cut, the pre-existing conditions have to go, too.

"There is no doubt that Republicans are responsible for the rising cost of healthcare premiums and the high likelihood that many will no longer be able to afford basic care at all, and they will face serious blowback in the midterms", the House Democrats' campaign operation said in a statement.

A bigger effect on premiums, according to both Corlette and Laszewski, are factors already in play that are expected to draw younger and healthier people out of the ACA marketplace.

"To not cover them at all, that's a problem", he said.

"Democrats destroyed the health care system as we knew when they rammed Obamacare down our throats", he said in an email, "and now all they can talk about is moving to a single-payer health care system".

Rep. Leonard Lance, New Jersey Republican, said he wasn't up to speed on the new case but he's hopes it will not force Congress to scramble for fixes.

The provisions DOJ says should be invalidated are central to the ACA and would gut protections for those with pre-existing conditions.

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