Medicine

The 'Biggest Health Care News of the Year'

The 'Biggest Health Care News of the Year'

Late Thursday, the department said the health law's requirement that most Americans carry insurance will become unconstitutional next year and so will consumer protections forbidding insurers to deny coverage to sick customers or charge them more.

In a brief filed in federal court this week, the department said that parts of the health care law should not stand.

The brief was filed in Texas v. Azar, a case brought in February by Texas and 19 other Republican-led states.

An NBC/Wall Street Journal poll released on Thursday - before the Trump administration decision was unveiled - found health care was the top issue for all voters and that it's an issue where Democrats have an overwhelming advantage. "At the worst it could strip away guaranteed coverage for those with pre-existing conditions".

The Trump administration is refusing to defend key parts of the Affordable Care Act, essentially arguing that federal courts should find the health law's protections for people with pre-existing conditions unconstitutional.

Though Republicans loathe the 2010 law, many of them have pushed for market-oriented solutions that allow sicker Americans to obtain insurance without facing sky-high prices. They say the rest of the law is not able to be separated from the mandate, and therefore should also be overturned. "The decision by the Department of Justice to abandon critical patient protections is devastating for the millions of Americans who suffer from serious illnesses or have preexisting conditions and rely on those protections under current law to obtain life-saving healthcare", read a joint statement from the American Cancer Society Cancer Action Network, the American Diabetes Association, the American Heart Association, the American Lung Association and the National Multiple Sclerosis Society. The lawsuit, led by Texas Attorney General Ken Paxton, contends that without an individual mandate, the entirety of the ACA, commonly known as Obamacare, is unconstitutional.

The administration's legal stance injects profound uncertainty into the political debate and the health-care landscape at a critical moment, just as insurance companies are developing rates for the coming year and as candidates head into a summer campaign season that both parties will try to use to solidify a foothold for their agendas. The government has essentially pivoted from defending the law to agreeing with the states that the court should demolish it.

"Zeroing out the individual mandate penalty should not result in striking important consumer protections", America's Health Insurance Plans said in a statement.

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Moreover, if the Trump administration did not want to defend the ACA expressly, it could simply have filed a jurisdictional motion, asserting that the states are not injured by the lack of an individual mandate penalty and that the litigation is not yet timely, as the tax is still in effect.

The Justice Department lawyers representing Trump's U.S. Department of Health and Human Services and Trump's Internal Revenue Services have asked the court to narrow the scope of the suit, and then to grant a ruling in favor of Texas and its allies on the narrower version of the suit. The Justice Department seeks a declaratory judgment that those provisions will be invalid as of January 1.

Legal specialists also point out that the Trump administration's failure to defend the federal health law could have long-lasting implications for the rule of law in the nation. "For the Trump administration to crumple that up and throw it out the window is galling".

ACA opponents argued even before the legislation creating the ACA was drafted that a mandate would be the equivalent of Congress requiring people who hate broccoli to buy broccoli.

Texas said that without the fine in place the requirement to have health insurance is unconstitutional and the entire law should be struck down as a result.

Rep. Tom MacArthur, New Jersey Republican, included a provision in the House bill that would have required insurers to cover sicker Americans but allowed states to waive the prohibition on charging them higher premiums.

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". The Trump administration is also trying to make it easier for healthier people to get less comprehensive health insurance, which would also take more healthy people out of the pool where most people buy their individual insurance.

Supporters of the health care law expressed considerable alarm on Friday.


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