Trump administration: Heart of health law unconstitutional

Trump justice department will stop defending key parts of Obamacare

Trump justice department will stop defending key parts of Obamacare

In a brief filed in a federal court in Texas, the department said a tax law signed previous year by President Donald Trump that eliminated penalties for not having health insurance rendered the so-called individual mandate under Obamacare unconstitutional.

But that mandate was crucial to persuading insurers to offer plans under the ACA.

For instance, existing rules would protect people with pre-existing conditions for twelve months if the ACA were struck down.

In a three-page letter to House Minority Leader Nancy Pelosi, D-Calif., Attorney General Jeff Sessions acknowledged "the Executive Branch has a longstanding tradition of defending the constitutionality of duly enacted statutes if reasonable arguments can be made in their defense". There is reason to believe the judge may accept the Trump administration's arguments. While the subsidies would not go away, it is unclear how their amount would be determined if insurers could return to the days before the law of charging higher prices to people with previous medical conditions - or refusing to cover them at all.More recently, the administration is in the midst of rewriting federal rules to make it easier for people to buy two types of insurance that are relatively low-cost because they bypass the ACA's requirements for benefits that health plans sold to individuals and small business must include. "A year and a half into sabotaging Americans' health care, this may be President Trump's meanest effort yet - he is working to let insurance companies refuse to cover sick people", Sen. There are about 21 million people who do so, buying either through insurance brokers or from a state or federal Affordable Care Act marketplace.

In many ways, the political fight over health care during the midterms had started before Thursday night, with Democrats already accusing Republicans of trying to snatch health coverage from American consumers. Estimates vary widely because there is not a standard definition of what counts as a pre-existing condition. Lisa Murkowski of Alaska and Susan Collins of ME, previously helped tank Republicans' efforts to repeal and replace the ACA citing their concerns over the possible elimination of coverage for people with pre-existing conditions.

According to healthcare.gov, a pre-existing condition is a health problem a person has before enrolling in a new health care plan. Of course, not all of them buy coverage on their own. Last year, Congress repealed the tax associated with the penalty, effective 2019.

Epilepsy, cancer, diabetes, lupus, sleep apnea, and pregnancy are all examples of pre-existing conditions.

More immediately, there might be some effect on premiums for next year.

Some experts have said that regardless of how the case is decided, insurers could raise premiums for next year due to the uncertainty the case is causing, a point echoed by the Democrats.

"The more uncertainty there is, the more the actuaries are going to be plugging into their projections for premium rates", says Sabrina Corlette, a research professor at Georgetown University's Health Policy Institute.

That penalty, Texas and the other conservative states argue, is so central to the law that without it, the rest can not stand. 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. Most famously, in 2012, a narrow majority led by Chief Justice John Roberts turned back a challenge that was also filed by Republican attorneys general along with the National Federation of Independent Business. When the 2017 Tax Cut and Jobs Act zeroed out the tax penalty amount as of 2019, the individual responsibility became entirely unconstitutional.

In 2015, the court ruled that Congress did not intend to provide financial aid exclusively for premiums to individuals in states that operated their own insurance exchanges.

Democrats swiftly portrayed the surprise move by the Justice Department, outlined Thursday in a brief supporting a court case filed by Texas and 19 other states, as a harsh blow to Americans with fragile health and their families.

It said the rest of the law, including Medicaid expansion, can remain in place.

Attempts to repeal it in Congress have failed, but opponents of the law have also filed scores of lawsuits challenging various provisions.

"I am at a loss for words to explain how big of a deal this is", University of MI law professor Nicholas Bagley said in a blog post. In the new suit, California is leading a group of Democrat-led states in defending the law. "We call upon the Administration to reverse this decision and defend the rights of our patients", Stewart said.

"Democrats destroyed the health-care system as we knew when they rammed Obamacare down our throats", Hunt said.

The guarantees for coverage for people with pre-existing conditions are among those most valued by the public.

The decision, announced in a filing in a federal court in Texas, is a rare departure from the Justice Department's practice of defending federal laws in court.

Kaiser Health News, a nonprofit news service, is an editorially independent program of the Kaiser Family Foundation and is not affiliated with Kaiser Permanente.