The 'Biggest Health Care News of the Year'

Pearl Mccarthy
June 11, 2018

The lawsuit, led by Texas Attorney General Ken Paxton, contends that without an individual mandate, the entirety of the ACA, commonly known as Obamacare, is unconstitutional. In the meantime, the existing law will likely remain.

"Congress is always free to amend its statutes, even to omit what it previously thought was essential", writes Nick Bagley, a law professor at the University of MI, in a Thursday evening blog post. "The decision by the Department of Justice to abandon critical patient protections is devastating for the millions of Americans who suffer from serious illnesses or have preexisting conditions and rely on those protections under current law to obtain life-saving healthcare", read a joint statement from the American Cancer Society Cancer Action Network, the American Diabetes Association, the American Heart Association, the American Lung Association and the National Multiple Sclerosis Society.

Republicans on Capitol Hill had no advance warning that the administration was going to assert that protections for people with preexisting conditions is unconstitutional - a position that defies President Donald Trump's promises to maintain those protections.

Bagley said the brief reveals the "depth of institutional decay at the Department of Justice", and he expressed profound concern about the precedent it sets.

Attorney General Jeff Sessions said in a letter to Congress on Thursday that Trump, who campaigned on repealing the law and almost did so his first year in office, approved the legal strategy.

But Rep. Steve King, Iowa Republican, said it's not unprecedented for the Justice Department to refuse to defend a law it views as unconstitutional, so he doesn't see their decision as problematic.

While Justice Department attorneys often advocate for laws they may personally disagree with, those three civil servants instead made a decision to exit from the case, which Bagley described as "almost unheard of". "United States are correct that Section 5000A (a) [the individual mandate] will be unconstitutional when the Jobs Act's amendment becomes effective in 2019".

That includes the 2010 law's rules protecting people with preexisting conditions and health insurance subsidies, which are life-and-death issues for many Americans with low to moderate incomes.

America's Health Insurance Plans, the main industry trade group, bemoaned the Justice Department's stance, saying it could upset a market that is becoming "more steady" for most consumers.

In that scenario, other ACA provisions would stay in place.

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And it didn't take long for Democrats to respond to the Trump administration's new posture.

"Removing those provisions will result in renewed uncertainty in the individual market, create a patchwork of requirements in the states, cause rates to go even higher for older Americans and sicker patients, and make it challenging to introduce products and rates for 2019", the statement said. On his first night in office, Trump issued an executive order, directing federal agencies to lighten the regulatory burden placed by the law.

That would mean insurers would no longer be subject to "guaranteed issue" (a requirement that they sell policies to anybody, regardless of medical status) or "community rating" (a prohibition on charging higher premiums to people with pre-existing conditions).

More than one in four adults younger than 65 have pre-existing medical conditions, according to the Kaiser Family Foundation.

Successfully defending Obamacare will, however, be a heavy lift. States such as California will take up the law's defense, and the legal battle will continue.

Currently, proposed rate increases range from 7 to 36 percent higher than 2018 but only up 2 percent on Silver plans for people who get tax credits to subsidize their premiums, according to a new premium tracker launched this month by the Kaiser Family Foundation.

After the latest attempt to repeal the health law failed with Arizona Sen. They must grapple with how to protect the state's insurance market amid a continued assault against the federal health law.

Senior House Democrats on health care committees called the administration's refusal to defend the federal health law a "stunning attack on the rule of law". Their lawsuit has contended that the entire ACA program can not function as an economic matter without the assurances of adequate numbers of people buying insurance. "The White House needs to hear that the American people will not stand for this", Murphy said. "But even if the Justice Department's arguments fail, as they should, the administration's violation of its duty to faithfully execute our nation's laws will still raise the cost of health care for most Americans, undermine the economy, and weaken our democracy for years to come".

"These attorneys are civil servants". Yet they could not sign it.

"Tonight, as the president and his administration launch their most unsafe sabotage effort yet, we are seeing just how far Republicans are willing to go in their quest to undermine the American health care system", said Brad Woodhouse, campaign director of Protect Our Care, an advocacy group staffed with many Obama administration alums.

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