GOP risks fallout over move on health law | Health care act

The Trump administration is calling a key part of Obamacare that protects individuals with pre-existing conditions unconstitutional

"The administration's attempt to eliminate protections for the 130 million Americans with pre-existing conditions is just the latest - and potentially the most damaging - example of the coordinated effort by congressional Republicans and the Trump administration to sabotage the Affordable Care Act, driving up uninsured rates and out-of-pocket costs for Americans", the Democrats said.

In an unusual filing just before 6 p.m. Thursday, when the brief was due, the three career Justice attorneys involved in the case - Joel McElvain, Eric Beckenhauer and Rebecca Kopplin - withdrew. Now they have a new talking point, and they lost no time testing it.

Several Republicans said Friday that if the administration did prevail, it would be their responsibility to step in and restore protections for people with preexisting conditions.

While the ACA has been the target of a sharply divided and partisan debate for almost a decade, pre-existing protections are one of the most popular actions Congress has taken in modern times. For starters, it's pretty rare for the DOJ (under any party's control) to come out against an existing US law since it's generally in the business of trying to defend the law's constitutionality. "Picking this fight going into the summer of an election year is mind-boggling".

But the administration disagrees with that position. In an NBC News/Wall Street Journal poll released this week, 22 percent of respondents said it would be the most important factor in deciding their vote, ahead of the economy, guns, taxes and immigration.

"This sabotage also has those with pre-existing conditions once again facing the prospect of denied coverage, increased costs, and medical bankruptcy". Even President Donald Trump called it one of the law's "strongest assets" during an interview with "60 Minutes" shortly after he won the election.

"So far as I can make out, the Trump administration will continue to enforce the ACA while the litigation progresses", Nicholas Bagley, an assistant professor who specializes in health law at the University of Michigan Law School, wrote Friday in a posting on the Incidental Economist site. Frank Pallone, D-N.J., a spokesman for his party on health care.

Though the lawsuit has a long path before it, Democrats and their allies are seizing on the administration's stance as a ready-made attack line as they try to retake the House in November.

As many as 130 million adults under age 65 in the USA have pre-existing conditions that could result in their not being able to get insurance coverage in the private market, according to the Department of Health and Human Services.

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She cited a report from health care think tank Kaiser Family Foundation that estimates more than 52 million Americans have pre-existing health problems that would "likely leave them uninsurable" if it weren't for the Affordable Care Act's regulations.

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

The 2010 law, passed by a Democratic Congress and a signature domestic accomplishment of President Barack Obama, created insurance "exchanges" in every state to sell federally subsidized coverage to individuals who do not have access to affordable health benefits through a job. 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".

If there is no tax penalty for not buying insurance now, then no taxation is taking place, so the other parts of the law tied to the individual mandate must go, the 20 GOP attorneys general argue.

But Sessions also said that he agrees with the Department of Justice's opinion at the time of the 2012 case, that if the mandate is unconstitutional, it is separate from the ACA's other provisions, except those guaranteeing issuance of coverage in the individual and group market.

The main trade association for health insurers came out strongly against the administration's position.

What it means: If successful, the states' lawsuit would allow insurers to charge much higher rates to people with pre-existing conditions, or deny them coverage altogether, effectively ending the ACA's promise of providing health care for all Americans. The Justice Department says only the protections for people with preexisting conditions are linked to the tax - not the rest of the law, including the expansion of Medicaid.

What do other states say?

California Attorney General Xavier Becerra, joined by 16 other attorneys general, said in April he would "vigorously" defend the ACA. "A compelling defense of the law is right there in black and white", Verrilli said in a statement.

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