Friday, 19 October, 2018

Trump administration move could take away coverage for preexisting conditions

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Gustavo Carr | 11 June, 2018, 07:37

The Justice Department said in a court filing late Thursday that it will no longer defend key parts of the Affordable Care Act, beginning with the unpopular requirement that people carry health insurance, but also including widely supported provisions that guarantee access for people with medical problems and limit what insurers can charge older, sicker adults.

But the administration disagrees with that position.

Republicans in Congress have tried endlessly to the repeal the Affordable Care Act since it was signed into law in 2010 by President Barack Obama.

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.

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 court said that while this "individual mandate" exceeded Congress' power to regulate commerce, it could be upheld as an exercise of Congress' taxing power. We also agree that the Affordable Care Act's (ACA) provisions affecting Medicaid, Medicare Advantage, and Medicare Part D should remain law.

Some critics of the administration's decision said California should go forward with enacting its own mandate for individual coverage, as a few other states have done. It argues that because the tax reform bill passed by Congress gets rid of the ACA's "individual mandate" penalty for not having health insurance, the requirement for individuals to have health insurance is void, and because of that, the rest of the law - which they say hinges on the mandate - should be invalidated. 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.

Sessions, in his letter to Ryan, said that the parts of the law restricting the variance in the premiums that could be charged and requiring insurers to cover everyone did hinge on the mandate, because without the mandate, "individuals could wait until they become sick to purchase insurance, thus driving up premiums for everyone else".

Senate Democratic Leader Chuck Schumer urged President Donald Trump to reverse the decision.

For instance, existing rules would protect people with pre-existing conditions for twelve months if the ACA were struck down.

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

"For three such respected DOJ attorneys to do so simultaneously - just hours before a major filing, and without replacement by any other career lawyers other than a rookie - is simply flabbergasting".

Timothy Jost, law professor emeritus at Washington and Lee University in Virginia said the Trump administration is trying to persuade the court to do what it was unable to achieve in Congress past year - essentially, repeal key parts of the Obama health law.

"At the very least it adds uncertainty at exactly the moment when plans are trying to set rates for next year", said Ceci Connolly, the chief executive of the Alliance of Community Health Plans.

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

The same report estimates 391,000 Utahns have pre-existing conditions that could affect their coverage eligibility.

And though the federal government will apparently no longer defend a pillar of the law, a group of left-leaning states have stepped in to back it in court. Energy and Commerce Ranking Member Frank Pallone, Jr., New Jersey, Education and the Workforce Ranking Member Bobby Scott, Virginia, and Ways and Means Ranking Member Richard Neal, Massachusetts, said the move by the DOJ breaks with the department's tradition of defending federal laws, regardless of whether it supports the underlying policies. Slavitt and others criticized the move as an unprecedented decision by the Justice Department to not defend the rule of 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. "Our coalition of states and partners across the country will fight any effort to strip families of their health insurance", he said.

The states' challenge to the overall ACA has been pending since February in the Fort Worth court of U.S. District Judge Reed C. O'Connor.