An obscure district court lawsuit over the Affordable Care Act became a potent threat to one of the law's most popular provisions late Thursday, when the Justice Department filed a brief arguing that as of January 1, 2019, the protections for people with pre-existing conditions should be invalidated.
The U.S. Justice Department says it will no longer defend major parts of the Affordable Care Act in court. "Instead, it exacerbates our current challenges and creates further uncertainty that could ultimately result in higher costs for millions of Americans and undermine essential protections for people with pre-existing conditions, such as asthma, heart disease, arthritis and diabetes", Collins said. O'Connor was appointed by George W. Bush and recently ruled that health care providers can not be forced to perform procedures that conflict with their religious beliefs. "I think what they're doing is wrong, I think their attempts to overturn the Affordable Care Act have been wrong, but look, they're the majority, they set the schedule". Bernard Sanders, I-Vt., to establish a single-payer health-care system, suggesting that would become the Democrats' agenda if they were to regain power.
Andy Kim, a former Obama administration staffer, is making coverage of pre-existing conditions and access to affordable health care a key part of his campaign against Rep. Tom MacArthur in Central New Jersey, the author of the Obamacare repeal bill that passed the House but failed in the Senate a year ago.
The ACA now requires insurance companies to offer coverage to everyone regardless of their medical history.
But Congress repealed the tax penalty for people without insurance previous year, and the individual mandate can no longer be described as a tax when the repeal takes effect in January, the brief says.
Twenty Republican state attorneys general filed suit on February 26, charging that Congress' changes to the law in last year's tax bill rendered the entire ACA unconstitutional.
A coalition of 20 US states sued the federal government in February, claiming the law was no longer constitutional after last year's repeal of the penalty that individuals had to pay for not having insurance.
Democrats, who were already favored going into this November's election both on the generic ballot and on health care in particular, pounced on the news of the lawsuit, predicting "serious blowback in the midterms" for Republicans.
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.
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Crusading against the ACA has been a priority of President Donald Trump since his campaign for the White House. With President Trump's tax reform package in December 2017 removing the individual mandate requirement as a tax penalty, the last remaining reasoning to having a mandate fell apart, the suit argues. "Congress has now kicked that flimsy support from beneath the law".
What do other states say?
America's Health Insurance Plans said Friday that it plans to file a brief opposing the plaintiffs' request for emergency relief that would provides detail about the harm that would come to millions of Americans should their request to invalidate the ACA is granted either in whole or in part.
Sessions said in his letter that the Justice Department was not arguing that the entire law does not pass constitutional muster. 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.
"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 new challenge comes six years after the Supreme Court's divided ruling that the ACA is constitutional.
Because the lawsuit could easily go all the way to the U.S. Supreme Court, a process that could take years, the protections for people with preexisting conditions are likely to stay in place during that period.
The Texas case will be decided first by O'Connor, a conservative appointee of President George W. Bush.