Published: Sun, June 10, 2018
Medical | By Vicki Mclaughlin

Trump administration: Heart of health law unconstitutional

Trump administration: Heart of health law unconstitutional

"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.

In 2012, the U.S. Supreme Court ruled that the individual mandate - requiring Americans to purchase insurance and exacting a yearly financial penalty from those who don't - was not a constitutional use of the Commerce Clause, but that it was a lawful use of Congress' authority to require taxes.

The decision by the department (DoJ) was announced in a filing in a federal court in Texas, part of a lawsuit brought by Texas and other Republican-led states to strike down the entire law.

The Justice Department thus claims that the individual mandate is unconstitutional as of January 1.

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

About 1.5 million Californians buy coverage through the state's ACA exchange, Covered California, and almost 4 million have joined Medicaid as a result of the program's expansion under the law.

The Department of Justice said it agrees with Texas that the so-called individual mandate will be unconstitutional without the fine. In the new suit, California is leading a group of Democrat-led states in defending the law.

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Bagley, a former Justice Department attorney, said the DOJ has a "durable, longstanding, bipartisan commitment" to defending the laws passed by Congress as long as there is a legitimate "non-frivolous" argument to be made in its defense. The rest of the ACA can function without the mandate, the brief says, and should be retained.

What are the ramifications of the Trump administration making these arguments? "The Trump Administration is perpetuating the same cruel vision of higher costs and less coverage that House Republicans voted for in the monstrosity of Trumpcare". The administration's argument would also allow insurers to charge women, older people, and people in certain occupations higher premiums.

Many advocates spoke out against the Trump administration's stance on the law's consumer protections. Tellingly, three career Justice Department attorneys withdrew from representing the United States immediately before filing the brief, apparently unwilling to sign their names to a legally questionable brief. Insurers say the individual health insurance market is more stable than people might think. This policy change would jeopardize coverage not just for consumers in the individual market, but also people with preexisting conditions who have employer-sponsored coverage.

More recently, the White House and Department of Health and Human Services have been working to make it easier for consumers to buy relatively low-priced health plans that exclude some of the benefits the ACA requires.

These consumer protections proved enormously popular with Americans and are among the reasons why efforts to repeal Obamacare in Congress failed past year.

"In refusing to follow bipartisan tradition and defend the ACA in the USA federal court system, the Trump administration is nakedly admitting that it wants to eliminate protections for people with pre-existing conditions, breaking a promise that the president has made time and again", said Topher Spiro, vice president of health policy at the Center for American Progress.

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