Another legal battle brews over health care law

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Getty Images

The Trump administration won't defend central provisions of the Affordable Care Act, saying in a legal filing Thursday night that key parts of the Affordable Care Act should be invalidated and that the individual mandate is unconstitutional.

But Rep. Steve King, Iowa Republican, said it's not unprecedented for the Justice Department to refuse to defend a law it views as unconstitutional, so he doesn't see their decision as problematic. 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.

Many health care experts disagree with that position.

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.

Senate Democrats have vowed to make health care policy a priority this summer, as they gear up for midterm elections this November.

Stanford said removing the restrictions on pre-existing conditions would take Americans back when "insurance companies could pore through your medical records and anything you mentioned to your doctor was fair game".

The attorneys general argue that a Supreme Court decision in 2012 saved the ACA from being declared an unconstitutional overreach of congressional power by declaring the penalty a tax - and pointing out that Congress has the power to levy taxes. If the Justice Department's analysis is ultimately persuasive, however, other parts of the law, including Medicaid expansion, could stay in place.

Jost said it's telling that three career Justice Department lawyers refused to support the administration's position. They were successful in repealing the individual mandate that requires all Americans to have health insurance after it was included in the GOP's tax reform legislation that Trump signed into law in December. The states argue that after Congress eliminated the penalty for the individual mandate previous year, effective in 2019, it destabilized other sections of the law.

Also, 39 percent of registered voters in today's NBC/WSJ said they are enthusiastic or comfortable with a candidate seeking to repeal Obamacare, compared to 49 percent who said they have reservations or were very uncomfortable with a candidate seeking to repeal the health care law.

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The Trump administration's startling decision to abandon one of the Affordable Care Act's most popular provisions - protections for people with preexisting medical conditions - put Republicans on the defensive Friday and handed Democrats a potentially potent political message.

As many as 130 million adults under age 65 in the US have pre-existing conditions that could result in their not being able to get insurance coverage in the private market, according to the Department of Health and Human Services. Under another provision, the community rating provision, insurers were not allowed to set premiums based on a person's health history. They will also have to contend with the following assertion from the Attorney General of the United States: "I have determined that the plaintiffs in Texas v".

Bailey's spokesman Corey Uhden said Friday that he wouldn't comment on the constitutionality of the ACA provisions.

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

California and 15 other states filed an opposing brief on Thursday defending the law.

"Withdrawing from a case en masse like this, right before the brief is filed, is unheard of", noted Nicholas Bagley, a former Justice Department lawyer who now teaches at the University of Michigan Law School.

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.

The Texas case will be decided first by O'Connor, a conservative appointee of President George W. Bush.

The lawsuit could easily go all the way to the Supreme Court before there is a resolution, which could take years. The case would then go to the 5th U.S. Circuit Court of Appeals, where appointees of Republican presidents hold a 10-5 majority over Democratic appointees.

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