Justice Department takes aim at heart of health law

Obamacare

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The U.S. Justice Department has told a Texas federal court that it won't defend provisions in the Affordable Care Act that ban insurers from refusing to cover people with pre-existing conditions and from charging them more money.

Linda Muller, president and CEO of Cornerstone Healthcare, the mid-Hudson's largest low-income health provider, said it would be disastrous if "an entire class of individuals with pre-existing conditions are targeted" by a federal decision not to support them.

The president last fall ended "cost-sharing reduction payments" to insurers that offset discounts that the law promises to lower-income customers in the out-of-pocket costs for ACA health plans.

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.

"Late last night, we informed a Texas court that we would not be defending the constitutionality of the Obamacare mandate", he continued.

The long-shot lawsuit argues that because Republicans repealed the ACA's individual mandate penalty as part of their tax overhaul, all of the remaining law is unconstitutional.

Chief Justice Roberts, who wrote the majority opinion in NFIB v. Sebelius, rejected the Obama administration's claim that Congress could impose the individual mandate pursuant to the Constitution's Commerce Clause.

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In court papers, lawyers for Texas asked a Texas judge to hold that the ACA is unlawful and enjoin its operation.

The nation's top insurers' lobby said Friday the administration's position is untenable and could destabilize the markets as insurers develop their offerings for next year. A December 2016 poll by the nonpartisan Kaiser Family Foundation found that 75 percent of Democrats and 63 percent of Republicans approved of the law's provision prohibiting insurance companies from denying coverage based on a person's health status or medical history.

The Justice Department concurred, saying the court should consider ordering that as of January 1, two popular parts of the law will be invalid: that people with preexisting conditions must receive coverage, and that they can not be charged more than healthier consumers.

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.

Mental disorders, including depression and anxiety, are also considered pre-existing conditions. Estimates vary widely because there is not a standard definition of what counts as a pre-existing condition.

The same report estimates 391,000 Utahns have pre-existing conditions that could affect their coverage eligibility. Prior to the ACA, insurers often rejected applicants who were ill or had pre-existing conditions or only offered them limited coverage. Of course, not all of them buy coverage on their own.

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.

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Don't look for big changes quite yet, though the move could boost premiums and reduce choices among plans as early as 2019. Ultimately, the issue could be decided by the Supreme Court. "The pre-existing condition protections are extremely popular on both sides of the aisle". Without restricting premiums most individuals may choose to go without.

America's Health Insurance Plans, the main industry trade group, bemoaned the Justice Department's stance, saying it could upset a market that is becoming "more steady" for most consumers.

Current best evidence on the Affordable Care Act's Medicaid expansion suggests that the improvements to quality care and in access to care and to some degree health have occurred.

But others say the legal brief may have minimal impact next year on premiums. 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.

AHIP said it agrees with the Trump administration that the plaintiffs should not be granted a preliminary injunction.

The Supreme Court has twice upheld the constitutionality of the health law. Now his administration is walking back on that promise in a major way. Trump extolled passage of the tax reform package as it nears, and celebrated the repeal of the Obamacare individual mandate included in the tax package.

In 2015, the court ruled that Congress did not intend to provide financial aid exclusively for premiums to individuals in states that operated their own insurance exchanges. United States argue that this rationale, such as it was, no longer applies because Congress reduced the tax-penalty to zero previous year.

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"Texans have known all along that Obamacare is unlawful and a divided Supreme Court's approval rested exclusively on the flimsy support of Congress' authority to tax", said Paxton when the suit was filed.

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