U.S. Department of Justice lawyers launched that attack on part of the ACA Wednesday, by asking a federal court in Texas to let the governments of Texas and other states that oppose the ACA win part of a suit they have filed - but only part of their suit.
In a letter penned by Attorney General Jeff Sessions, the administration declares that it will not defend the existing law of the land contained within the ACA and will instead side with the plaintiffs in the contention that it is unconstitutional to require most Americans to have health insurance and that, by extension, any mandated protections in the ACA preventing insurance companies from discriminating against people living with pre-existing conditions are no longer valid.
The Trump administration filed a brief in the case on Thursday, arguing that without the tax to encourage healthy people to sign up, the parts of the law guaranteeing coverage to people with previous health conditions without charging them higher rates should be struck down as well. That ruling hinged on the reasoning that, while the government "does not have the power to order people to buy health insurance", as Chief Justice John Roberts wrote for the majority, it "does have the power to impose a tax on those without health insurance".
Many lawmakers were playing catch-up with the fledgling case, though Rep. Michael Burgess, Texas Republican, said there could be a "silver lining" if the courts force Congress to revisit heath care under the threat of losing Obamacare's protections for people with pre-existing conditions next year.
The provisions the Justice Department wants the court to invalidate are central to the ACA, or Obamacare, and would gut protections for those with pre-existing conditions. They included provisions establishing health insurance exchanges, expanding Medicaid coverage and subsidizing premiums for lower-income people.
Attorney General Jeff Sessions said in a letter to Congress that Trump, who campaigned on repealing the law and almost did so his first year in office, approved the legal strategy.
About 1.5 million Californians buy coverage through the states ACA exchange, Covered California, and almost 4 million have joined Medicaid as a result of the programs expansion under the law.
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On Thursday, the US Justice Department proclaimed that the part of the Affordable Care Act requiring people to have health insurance was unconstitutional. One of their replacements is Brett Shumate, described by the Times as "a Trump administration political appointee in the civil division of the Justice Department who has played a leading role in defending the White House in a range of lawsuits".
America's Health Insurance Plans (AHIP), a trade group for health insurers, today put out a statement arguing that eliminating the current underwriting rules for 2019 would lead to major disruption in the individual major medical market. In that, lawmakers chose to eliminate the tax penalty the ACA requires people to pay if they flout the insurance mandate. Sessions aruged that a mandate repeal, or a mandate without a tax, causes the essential benefits protections of ACA to become invalid. Health insurers are now deciding whether to sell coverage in the individual market in 2019 - and what they're going to charge.
Some critics of the administrations decision said California should go forward with enacting its own mandate for individual coverage, as a few other states have done. First, if the administration's position prevails, millions of Americans will lose the protections they thought they had against being denied coverage if they suffer from preexisting conditions.
"The Trump administration once again is allowing premiums to go up and middle class Americans to pay more", Senate Minority Leader Chuck Schumer said in a tweet. Ultimately, the issue could be decided by the Supreme Court. What the Justice Department is arguing is that most of the rest of the law is still OK.
"The decision would cut out the heart of the ACA and completely rewire the health insurance markets", he said. This is the Trump Administration's latest and most risky step yet to repeal and sabotage our care. The lawsuit injects more uncertainty into what is already an uncertain environment for insurers.
But Bagley noted that the Trump administration "loathes the ACA" and the Obama administration's refusal to defend Defense of Marriage Act, a federal law that defined marriage between a man and a woman back in 2011, sets precedent.