USA to No Longer Defend Key ACA Provisions


They are logically separate from the individual mandate. However, in NFIB v. Sebelius the Obama DOJ argued that the mandate was not severable from two of the law's crucial provisions - guaranteed-issue and community rating. The administration instead called on federal courts to scuttle the health laws protection for people with preexisting medical conditions and its requirement that people buy health coverage.

Attorney General Jeff Sessions wrote a letter to House Speaker Paul Ryan explaining that this is a "rare case" that warrants deviating from the Justice Department's "longstanding tradition of defending the constitutionality of duly enacted statutes". The states argue that after Congress eliminated the penalty for the individual mandate past year, effective in 2019, it destabilized other sections of the law.

Plans have requested a 24% rate increase on average for 2019, with about half that amount tied to the elimination of the individual mandate. So what these Republican attorneys general are arguing is that without the penalty everything else in the law is unconstitutional.

The Trump administration Thursday did not go that far. First, if the administration's position prevails, millions of Americans will lose the protections they thought they had against being denied coverage if they suffer from preexisting conditions.

The theory went something like this: If you aren't compelled to buy insurance when you're healthy, but you're allowed to buy it when you find out you are sick, then only sick people would buy health insurance. But it did say that the ACA provisions on pre-existing conditions are so linked to the individual mandate that it should now be struck down. Estimates vary widely because there is not a standard definition of what counts as a pre-existing condition.

More than one in four adults under the age of 65 have existing medical conditions, according to Kaiser Family Foundation.

Q: How can the federal government refuse to defend a federal law?

Led by Texas Attorney General Ken Paxton and Wisconsin Attorney General Brad Schimel, the lawsuit said that without the individual mandate, Obamacare in its entirety was unlawful.

The legal motion is mostly symbolic and any substantive action in the lawsuit will likely take months.

"Otherwise individuals could wait until they become sick to purchase insurance, thus driving up premiums for everyone else", Sessions said in his letter to Pelosi.

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.

How is this lawsuit different from previous challenges to the ACA?

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"Final resolution of this case will take time, given that the litigation is in its preliminary stages at the district court, and any ruling will be subject to appeal".

Just hours before the Justice Department officially withdrew from the case, three of the staff attorneys who had been working on it withdrew. Now, of course, as I mentioned, the attorneys general say that the entire rest of the law is unconstitutional without that penalty for not having insurance.

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.

"Texans have known all along that Obamacare is unlawful and a divided Supreme Court's approval rested exclusively on the flimsy support of Congress's authority to tax", said Paxton when the suit was filed.

Other legal observers point out that's not how the law-making process works.

Thursday's filing doesn't put the law in immediate danger. The 2012 SCOTUS ruling precludes any claim that Congress had the authority to impose the mandate pursuant to its powers under the Commerce Clause. So we don't have to speculate what Congress would've done if it had a choice between invalidating the ACA's insurance reforms or just invalidating the mandate.

The state has been at the forefront in resisting many Trump Administration policies, including on health care and immigration. Some legal experts say the suit is weak, since it turns on the idea that if one part of a law is invalid, the whole thing is invalid, without recognizing that the Congress passed the law and is free to alter it while leaving the rest in place. “California will fight like hell to protect our families and their healthcare.”.

If nothing is going to happen right away, why is this such a big deal? Even if the lawsuit stands little chance of success, putting those provisions back in play can create uncertainty for insurers and patients this summer and fall.

MacArthur's district is a target for Democrats attempting to flip at least 23 House seats the party needs to take control of the chamber after the November election.

"I've long held a position that the federal government should get completely out of the health insurance business", he said. 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.

This is a huge deal... the administration's behavior sets a unsafe precedent about the obligation of this and future presidents to follow their constitutional duty to faithfully execute the laws enacted by Congress....