“The
Mueller Report” is so last week’s news. Health care has
returned in force as the dominant political issue in Washington, reflecting
what voters have been telling pollsters for the past year.
The
Trump administration moved Monday night to get more in line with President
Donald Trump’s voter base by endorsing a Texas federal judge’s December opinion
that the entire Affordable Care Act should be struck down as unconstitutional.
After
he arrived at the Capitol for lunch with Republican senators Tuesday, Trump
endorsed the change, suggesting it will usher in Republican priorities instead.
“The Republican Party will soon be known as the ‘party of health care!’” he
told reporters.
Less
than two hours later, House Democrats unveiled their proposals to not only
protect the health law, but also expand it — including extending help paying
premiums and other costs to families higher up the income scale than those now
eligible and reinstating cuts made by the administration for outreach to help
people sign up for coverage.
Speaker
Nancy Pelosi said that, since taking control of the House in January, Democrats
have been fighting to preserve the health law and “voted on Day One” to file a
motion in the Texas court case to support the ACA.
The
arguments are a return to one of the key battles during the 2018 midterm
elections. Democrats hammered their Republican opponents on the GOP’s two-year
efforts to repeal the ACA — and especially its popular protections for people
with preexisting medical problems and Medicaid expansion — and credited those
attacks for big gains the party scored in the House and legislatures around the
country.
House
Majority Leader Steny Hoyer said those Democrats were elected to “protect and
expand” the health law. He warned Republicans not to undermine it, saying,
“Americans don’t want to see the ACA protections undone.”
The new
filing in the Texas case marks an about-face for the Justice Department. The
Republican attorneys general and governors who brought the case argued that
when Congress zeroed out the tax penalty for people who lacked health coverage
as part of the 2017 tax bill, the entire Affordable Care Act was rendered
unconstitutional. In December, U.S. District Judge Reed O’Connor agreed with them,
although he put his ruling on hold while the case is on appeal.
At that
time, the Justice Department did not endorse the GOP plaintiffs’ argument. It
suggested instead that the elimination of the tax penalty should invalidate
only those parts of the health law most closely associated with it — notably,
the provisions requiring insurance companies to sell to people with preexisting
conditions and not charge them more.
The
health law is being defended by a group of Democratic attorneys general, led by
California’s Xavier Becerra. They filed their brief Monday night, just before
the Justice Department issued its position change.
“The
Affordable Care Act is landmark legislation that has transformed the nation’s
healthcare system,” said the brief. Striking it
down “would strip existing healthcare coverage from millions of Americans” and
“it would make a mockery of the dramatic votes in which the same Congress
rejected earlier efforts to repeal or substantially revise the ACA.”
The
Department of Health and Human Services declined to comment on the change of
position, which was filed as part of the appeal process. Kerri Kupec, a spokeswoman
for the Justice Department, said the department “has determined that the
district court’s comprehensive opinion came to the correct conclusion and will
support it on appeal.”
Trump
has repeatedly called for the law to be repealed and replaced, but when
Republicans controlled Congress they could not muster the necessary votes. Just
last week, the president lashed out Sen. John McCain (R-Ariz.), who died in
August, for failing to support that effort.
If the
law is invalidated, it would not only directly affect the 11 million people who
purchase insurance through the ACA marketplaces, but also millions of
low-income people who gained coverage under the expansion of the federal-state
Medicaid health program. The Urban Institute estimates
full repeal would result in nearly 20 million more uninsured Americans.
The ACA
also includes substantial changes to the Medicare program, extends protections
to people with employer-provided insurance and includes such seemingly
unrelated provisions as requiring calorie counts on restaurant menus and making
it easier to make generic copies of expensive biologic drugs.
Health
analysts warn that the law is so embedded into the fabric of the nation’s
health system that eliminating it could have consequences well beyond
the things it created.
“The
act is now part of the plumbing of the health-care system,” wrote University of
Michigan law professor Nicholas Bagley in a post for the
Incidental Economist website. “Which means the Trump administration has now
committed itself to a legal position that would inflict untold damage on the
American public.”
Democrats,
who already had their health event scheduled for Tuesday, were quick to pounce
on what they see as a GOP weakness.
“In two
short sentences, the Trump administration crystallized its position that the
health care coverage enjoyed by nearly 20 million people, as well as the
protections by tens of millions more with preexisting conditions, should be
annihilated,” said Senate Minority Leader Chuck Schumer on the floor Tuesday
morning.
Democratic
presidential candidates also voiced their opposition.
“I’ll
say it for the zillionth time: We will not let the Trump administration rip
health care away from millions of Americans. Not now. Not ever,” tweeted Sen.
Elizabeth Warren (D-Mass.).
Sen.
Kamala Harris (D-Calif.) said in an interview on MSNBC that health care is “one
of the biggest most critical issues facing American families. the existence of
preexisting conditions and that being a barrier to people having access to
health care. We decided as a nation” that it was wrong, she said, to deny
someone with a preexisting condition access to health care, and that the
Republicans’ latest move amounts to “playing politics with people’s public
health.”
[Update:
This story was updated at 4:30 p.m. ET to reflect developing news events.]
https://khn.org/news/trump-administration-changes-course-asks-court-to-strike-down-aca/?utm_campaign=KFF-2019-The-Latest&utm_source=hs_email&utm_medium=email&utm_content=71212282&_hsenc=p2ANqtz-9BTCvXxoEgixsYMyoOcAORe95Hbq-PSha6S6zEs01x8xB_g45rJ3dZdygY0ukg4E6pCUYC1IfjmENxuXYYFoj9hYC39A&_hsmi=71212282
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