October 20, 2018

Justice Department Moves to Strike Down Pre-Existing Conditions

11 June 2018, 07:36 | Silvia Roy

Wiki Media

United States District Court for the Northern District of Texas- Fort Worth

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.

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.

Mr. MacArthur said it would be hard for Congress to revisit the brutal health care fight, although it's unclear if the lawsuit will get "any legs under it".

Why they did it: Republicans have targeted the Affordable Care Act for elimination ever since it passed, and President Trump continues to promise that it will be overturned.

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. But the uncertainty it creates in the meantime could rattle the law's insurance marketplaces just as insurers are starting to file rate requests for next year.

Some critics of the administration's decision said California should go forward with enacting its own mandate for individual coverage, as a few other states have done. Texas and other Republican-led states are suing to strike down the entire law because Congress recently repealed a provision that people without health insurance must pay a fine.

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So why then, as Gizmodo reports, is Trump's Department of Justice now arguing in court that the ACA's pre-existing condition provisions are unconstitutional?

The health care law's core consumer protections, which the president once signaled he supported, have been among the most popular parts of the law and have helped extend coverage to millions of previously uninsured Americans.

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.

Senate Democratic Leader Chuck Schumer of NY urged President Donald Trump to reverse the decision. The mandate has always been a sticking point for conservatives, who argue that the government should not be telling individuals what coverage they must have.

Attempts to repeal it in Congress have failed, but opponents of the law have also filed scores of lawsuits challenging various provisions. They will also have to contend with the following assertion from the Attorney General of the United States: "I have determined that the plaintiffs in Texas v".

"At the very least it adds uncertainty at exactly the moment when plans are trying to set rates for next year", said Ceci Connolly, the chief executive of the Alliance of Community Health Plans.

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The same report estimates 391,000 Utahns have pre-existing conditions that could affect their coverage eligibility.

"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. "A compelling defense of the law is right there in black and white", Verrilli said in a statement.

Just hours before the Justice Department officially withdrew from the case, three of the staff attorneys who had been working on it withdrew. Other findings include: health insurance gains were largest for adults without a college degree; long term and short term un-insurance rates declined; use of primary care, mental health services and preventive care among enrollees increased; as well as more low and moderate care adults had more regular source of care; and reliance on ER departments decreased. Without it, all of the ACA's regulations should be invalid, they said, citing a 2012 Supreme Court ruling. But Martin S. Lederman, a Georgetown University law professor who was a Justice Department official in the Obama administration, called the mass withdrawal a likely sign of distress.

"It's highly unlikely NY would take away consumer protections it has put in place", said a spokeswoman for the state Health Plan Association.

The suit is being heard by Judge Reed O'Connell, who was appointed by President George W. Bush and has ruled against the ACA in other cases the past few years.

The lawsuit could easily go all the way to the Supreme Court before there is a resolution, which could take years.

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