The Trump administration told a federal court on Thursday that it would no longer defend crucial provisions of the Affordable Care Act because they were part of an unconstitutional scheme that required most Americans to carry health insurance.
One Utah health advocacy group warned Friday that the move could have negative financial consequences for hundreds of thousands of Utahns with pre-existing health conditions.
"The DOJ has now acknowledged the problems with the statute".
The Trump administration's move drew strong criticism from defenders of the health care law and some legal scholars, who noted how unusual it is for the Justice Department not to defend federal law. Health insurance costs already are rising, and recent reports by the nonpartisan Congressional Budget Office say two actions by Republicans have fueled the rises: the GOP tax law's elimination of the individual mandate, which allows healthy people to drop coverage without a penalty and thus leading to a costlier risk pool, and Trump's decision to cut off "cost-sharing" payments to insurers who take on sicker patients. If the Justice Department's analysis is ultimately persuasive, however, other parts of the law, including Medicaid expansion, could stay in place.
"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. But take a moment to marvel at the position the administration has taken: They think insurance companies should once again be able to deny you coverage or charge you outrageous premiums because you have a pre-existing condition. The letter acknowledges that the decision not to defend an existing law deviates from history but contends that it is not unprecedented. It "has chose to abandon the hundreds of millions of people who depend on" the law, he said in an interview with Kaiser Health News. The so-called individual insurance mandate is beyond Congress's power, the new filing argued, now that Congress has eliminated the financial penalty.
The administration called on the court to declare that the provisions that guarantee coverage will be "invalid beginning on January 1, 2019", when the mandate penalty goes away. 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 affordable because they bypass the ACA's requirements for benefits that health plans sold to individuals and small business must include. But the lawsuit argues that since the mandate can no longer raise any revenue, the mandate itself is now unconstitutional - and so is the entire ACA. "Congress has now kicked that flimsy support from beneath the law".
"The Justice Department's refusal to defend the Affordable Care Act in federal court is a stunning attack on the rule of law, the stability of our health care system, and Americans" access to affordable health care", said Reps. "At the worst it could strip away guaranteed coverage for those with pre-existing conditions". "The pre-existing condition protections are extremely popular on both sides of the aisle".
"There's some hope that they will prevail", Stanford said. "But to have one without the other doesn't make any sense". The administration decided its "dislike for the Affordable Care Act outweighed its respect for the rule of law".
"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", said America's Health Insurance Plans, one of the industry's main lobbying groups.
The overall ACA and the state-run marketplaces where subsidized health insurance is sold have continued to operate in the six years since the Supreme Court had upheld the individual-insurance mandate, but have often had difficulty holding down insurance premiums and have had a steady erosion of the number of insurance companies willing to continue to sell policies on those exchanges, even with subsidies that help them offset the cost of keeping premiums down.