What To Watch For As Trump Takes Aim At ACA Protections

The Trump administration is calling a key part of Obamacare that protects individuals with pre-existing conditions unconstitutional

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 Trump administration's decision to abandon the Affordable Care Act in an ongoing court challenge could affect some of the most popular pillars of the law - further intensifying the fight over health care in the middle of an election year.

Besides urging nullification of the insurance-buying mandate itself, the new government position argued that two of the most popular features of the ACA must fall along with it: the requirement that insurance companies can not deny health insurance to individuals because of existing or pre-existing medical conditions, and the requirement that they can not charge higher insurance premiums based on existing or pre-existing conditions.

Republicans have been trying to dismantle the Affordable Care Act - a centerpiece of President Barack Obama's legacy - since it was enacted in 2010 without any Republican votes. "Congress needs to work in a bipartisan manner to develop a solution that covers pre-existing conditions and makes health care more affordable and accessible for every American".

Some 70 percent of folks said the federal government should continue prohibiting insurers from charging more to those with pre-existing conditions, according to a Kaiser Family Foundation poll from June 2017. The court said that while this "individual mandate" exceeded Congress' power to regulate commerce, it could be upheld as an exercise of Congress' taxing power. If the Justice Department's analysis is ultimately persuasive, however, other parts of the law, including Medicaid expansion, could stay in place.

That includes the requirement that people have health insurance and sections that guarantee access to coverage regardless of any medical conditions, the Associated Press reported.

The legal challenge led by the state of Texas argues that these consumer protections - as well as the law's multibillion-dollar program for expanding the Medicaid safety net to poor Americans - should be scrapped because Congress past year repealed the penalty on Americans who don't have health coverage. The filing is part of a lawsuit brought by the state of Texas and a coalition of other Republican-led states that are challenging Obamacare's constitutionality.

California Attorney General Xavier Becerra pledged Friday to redouble his efforts as the Affordable Care Act's leading defender, saying attacks by the Trump Administration threaten health care for millions of Americans. United States argue that this rationale, such as it was, no longer applies because Congress reduced the tax-penalty to zero past year.


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....

The state has been immune to some of the turmoil underway in other parts of the country, where insurance options have dwindled to just one or two plans in some counties. Under another provision, the community rating provision, insurers were not allowed to set premiums based on a person's health history. Before the ACA passed, insurers commonly refused coverage for people with cancer, heart failure, diabetes, arthritis and even less serious conditions.

"Just read the brief of the states that intervened to defend the law. It's being mugged", King said in a twitter statement on Friday.

Three career lawyers in the department's civil division withdrew from the case earlier Thursday and did not sign the brief. Slavitt and others criticized the move as an unprecedented decision by the Justice Department to not defend the rule of law.

"I find it impossible to believe that the many talented lawyers at the department could not come up with any arguments to defend the ACA's insurance market reforms, which have made such a difference to millions of Americans", Verrilli said.

Ironically, the existence of that financial penalty in the law was what had saved the individual insurance mandate from being struck down by the Supreme Court six years ago.

The Trump administration's move drew comparisons to the Obama administration's decision, in 2011, to stop defending the constitutionality of the Defense of Marriage Act, a law that barred federal recognition of same-sex unions that were lawful at the state level, and which the Supreme Court later struck down. U.S. District Judge Reed O'Connor is presiding.

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