Trump Administration Moves To Further Hobble Affordable Care Act

12 June, 2018, 06:09 | Author: Darrell Lopez
  • The Trump administration is calling a key part of Obamacare that protects individuals with pre-existing conditions unconstitutional

"The mandate is "'essential' to the operation of [those] provisions" because they can not work without the coverage requirement, the department said. They are logically separate from the individual mandate. It helped expand their risk pools while the law forced them to guarantee coverage to any customer.

The provisions banning insurers from denying coverage or charging more based on medical condition or history can't be severed from the unconstitutional individual mandate, the brief says.

Twenty Republican state attorneys general filed suit on February 26, charging that Congress' changes to the law in last year's tax bill rendered the entire ACA unconstitutional.

The administration does not go as far as the Texas attorney general and his counterparts.

Their reasoning was borrowed from Barnett, who had proposed in his article that while the Congress has the power to regulate existing commercial activities, it can't force people to undertake a commercial activity they are not already engaged in.

Attorney General Jeff Sessions took the position that provisions such as the individual mandate and protections for patients with pre-existing conditions should be invalidated starting in January 2019.

If this lawsuit succeeds, who would be affected? Experts believe that could entice healthier people to exit the marketplace in favor of less-expensive, short-term plans, leaving the marketplace with a sicker population that could drive insurance costs higher.

ACA opponents argued even before the legislation creating the ACA was drafted that a mandate would be the equivalent of Congress requiring people who hate broccoli to buy broccoli. Estimates vary widely because there is not a standard definition of what counts as a pre-existing condition. Prior to the ACA, insurers often rejected applicants who were ill or had pre-existing conditions or only offered them limited coverage. Of course, not all of them buy coverage on their own. "The last time the health insurance business worked right was before the federal government got involved". The court ruled that the individual mandate was unconstitutional under Congress's Commerce Clause power as Congress can not compel individuals to participate in an area of commerce.

The second is the community rating provision.

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




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

More immediately, there might be some effect on premiums for next year. Jost wrote that the development puts health insurers in a quandry, since they are now setting rates for the individual market in 2019.

The Trump administration handed Democrats a political gift by arguing in court that Obamacare's most popular provisions are unconstitutional, just five months before a midterm election in which health care ranks as voters' top issue. Sessions aruged that a mandate repeal, or a mandate without a tax, causes the essential benefits protections of ACA to become invalid.

How is this lawsuit different from previous challenges to the ACA? That's not exactly what the attorneys general were arguing, but that's what the Justice Department position is. "In practice, this likely would exclude from the commercial health insurance markets individuals with preexisting conditions, individuals with illnesses that are expensive to treat, and many individuals over the age of 50 or 55". The lawsuit from a coalition of state attorneys general and two governors says Congress' decision to repeal the individual mandate penalty in ObamaCare makes the healthcare law illegal.

Q: Wait, Obamacare is in court again?

Other legal observers point out that's not how the law-making process works. The 2012 SCOTUS ruling precludes any claim that Congress had the authority to impose the mandate pursuant to its powers under the Commerce Clause.

The state has been at the forefront in resisting many Trump Administration policies, including on health care and immigration.

California and 15 other states also filed a brief Thursday to intervene and defend the ACA and its consumer protections. "The ACA is the law of the land and DOJ should defend it".

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....

SIMON: Julie Rovner, chief Washington, DC, correspondent for Kaiser Health News.

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