Republicans wants to take away your healthcare, Democrats want to expand it

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The Trump administration had previously argued to the federal court that the Affordable Car Act aka “Obamacare” protections for people with pre-existing conditions should be struck down — while blatantly lying to voters that Republicans wanted to protect people with pre-existing conditions last year — but is now arguing to the federal court that the entirety of the law, including the expansion of Medicaid, should be struck down because the GOP-controlled Congress sabotaged the individual mandate tax penalty under the law. The GOP is trying to do in the Courts what the GOP-controlled Congress could not do legislatively or administratively. Trump Officials Broaden Attack on Health Law, Arguing Courts Should Reject All of It.

If the appeals court accepts the Trump administration’s new arguments, millions of people could lose health insurance, including those who gained coverage through the expansion of Medicaid and those who have private coverage subsidized by the federal government.

“The Justice Department is no longer asking for partial invalidation of the Affordable Care Act, but says the whole law should be struck down,” Abbe R. Gluck, a law professor at Yale who has closely followed the litigation, said on Monday. “Not just some of the insurance provisions, but all of it, including the Medicaid expansion and hundreds of other reforms. That’s a total bombshell, which could have dire consequences for millions of people.”

The new position is also certain to reignite a political furor over the Affordable Care Act, ensuring that it will figure even more prominently in the 2020 elections. Democrats have been saying that President Trump still wants to abolish the law, and they can now point to the Justice Department’s filing as evidence to support that contention.

The Justice Department disclosed its new stance in a two-sentence letter to the United States Court of Appeals for the Fifth Circuit, in New Orleans, and will elaborate on its position in a brief to be filed later.

In the letter, the Justice Department said the court should affirm a judgment issued in December by Judge Reed O’Connor of the Federal District Court in Fort Worth.

Judge O’Connor, in a sweeping opinion, said that the individual mandate requiring people to have health insurance “can no longer be sustained as an exercise of Congress’s tax power” because Congress had eliminated the tax penalty for people who go without health insurance.

Accordingly, Judge O’Connor said, “the individual mandate is unconstitutional” and the remaining provisions of the Affordable Care Act are also invalid.

Note: “Legal experts across the political spectrum say O’Connor’s decision is so flawed and threadbare of logic that it’s likely to be overturned, and rapidly, by the 5th Circuit U.S. Court of Appeals in New Orleans. It could also be tossed by the Supreme Court, which has upheld the constitutionality of the ACA twice.” That Texas judge’s ‘insane’ ruling that Obamacare is unconstitutional could leave the law fatally wounded. “But in today’s political and juridical environment anything can happen.”

In its letter to the appeals court, the Justice Department said on Monday that it “is not urging that any portion of the district court’s judgment be reversed.” In other words, it agrees with Judge O’Connor’s ruling.

In other words, the Trump administration is relying on a decision from a conservative activist judge who rendered a political decision that is deeply flawed legal opinion in order to blow up the American health care system, out of spite for President Obama.

Lawyers said invalidation of the entire law would raise numerous legal and practical questions. It is, they said, difficult to imagine what the health care world would look like without the Affordable Care Act.

The Trump administration’s new position was harshly criticized by the insurance industry and by consumer advocates.

The government’s position “puts coverage at risk for more than 100 million Americans,” said Matt Eyles, the president and chief executive of America’s Health Insurance Plans.

Leslie Dach, the chairman of Protect Our Care, a consumer advocacy group, said: “In November, voters overwhelmingly rejected President Trump’s health care repeal and sabotage agenda. But he remains dead set on accomplishing through the courts what he and his allies in Congress could not do legislatively: fully repeal the law, devastate American health care and leave millions of Americans at risk.”

The Trump administration’s new stance appears to put Republicans in Congress in an awkward position. They have repeatedly tried to repeal the health law. But in the last year, Republicans said over and over that they wanted to protect coverage for people with pre-existing conditions — they lied! — and those protections are among the law’s most popular provisions.

The lawsuit challenging the Affordable Care Act, Texas v. United States, was filed last year by a group of Republican governors and state attorneys general. Officials from California and more than a dozen other states have intervened to defend the law.

The Texas lawsuit “is as dangerous as it is reckless,” Xavier Becerra, the attorney general of California, said on Monday as he filed a brief urging the appeals court to uphold the law.

While Republican are hellbent on taking away your healthcare and causing economic chaos by blowing up the American healthcare system, Democrats are seeking to expand and improve your healthcare. They are on your side. House Democrats to Unveil Plan to Expand Health Coverage:

Democrats won control of the House in large part on the strength of their argument that Congress needs to protect people with pre-existing medical conditions and to lower the cost of health care.

On Tuesday, Democratic leaders, including Speaker Nancy Pelosi, will put aside, at least for now, the liberal quest for a government-run “Medicare for all” single-payer system and unveil a more incremental approach toward fulfilling those campaign promises. Building on the Affordable Care Act, they would offer more generous subsidies for the purchase of private health insurance offered through the health law’s insurance exchanges while financing new efforts to increase enrollment.

They would also reverse actions by the Trump administration that allow insurance companies to circumvent protections in the Affordable Care Act for people with pre-existing conditions. Insurers could no longer sell short-term health plans with skimpy benefits or higher premiums for people with chronic illnesses.

Ms. Pelosi said the legislation would “strengthen protections for pre-existing conditions, reverse the G.O.P.’s health care sabotage and lower Americans’ health costs.”

The legislative package, put together by Ms. Pelosi and several House committee chairmen, builds on the health law that the speaker was instrumental in passing — and that was signed by President Barack Obama almost exactly nine years ago. And it seems to answer a question facing Democrats since they took control of the House: How would they balance the expansive demands of their most liberal members with the needs of more pragmatic Democrats elected in seats that were held by Republicans?

Ms. Pelosi, the committee chairmen and many other House Democrats see the new legislative package as a more efficient way of achieving universal coverage, a goal shared by champions of “Medicare for all,” led by Representatives Pramila Jayapal of Washington and Debbie Dingell of Michigan.

Democrats said they would probably try to pass the legislative package piece by piece, with the first votes on the House floor expected in May. Some elements could win support from Republican House members and from the Republican-controlled Senate.

With their new proposal, House Democratic leaders hope to finesse the disagreements within their caucus and to focus public attention instead on the gulf that separates Democrats of all stripes from President Trump on health care.

In his latest budget request, Mr. Trump urged Congress again to repeal the expansion of Medicaid under the Affordable Care Act, which has provided coverage to at least 12 million people newly eligible for the program.

And in the economic report of the president, the White House boasted last week about how Mr. Trump had allowed small businesses and individual consumers to buy insurance plans that skirt many requirements of the Affordable Care Act, offering lower costs but fewer benefits.

Under a rule issued in August, Mr. Trump greatly expanded the market for sales of short-term insurance plans that do not have to cover prescription drugs, maternity care, drug abuse treatment or pre-existing conditions.

The House Democrats’ bill would turn back the president’s action by stipulating that short-term plans are included in the definition of “individual health insurance coverage” under the Affordable Care Act and therefore must comply with coverage requirements of the health law.

These junk plans discriminate against people with pre-existing conditions,” said Representative Frank Pallone Jr., Democrat of New Jersey and an architect of the new legislation. “They deny access to basic benefits. They set arbitrary dollar limits for health care services, leading to huge surprise bills for consumers.”

We passed the Affordable Care Act to rein in exactly these types of abuses,” said Mr. Pallone, who is investigating the short-term plan as chairman of the Energy and Commerce Committee.

The Affordable Care Act provides two main types of financial assistance to people of modest means buying private insurance: tax credits to help them pay premiums, and cost-sharing reductions to lower their deductibles, co-payments and other out-of-pocket costs.

The House Democrats’ bill would revise the law to provide more of both types of assistance.

In addition, the bill would make subsidies available to some working families who are now ineligible. The law, as interpreted by the Internal Revenue Service, bars subsidies to workers who have access to affordable employer-sponsored coverage for themselves — even if the cost of coverage for the entire family is unaffordable. The House Democrats’ bill would eliminate this quirk in the law, sometimes called the family glitch.

The bill would also provide money to publicize the insurance options and subsidies available under the Affordable Care Act and to help people enroll. Mr. Trump has cut the budget for such efforts by more than 80 percent, saying the funds were no longer needed because people were now well aware of the law.

House Democrats would also block guidance issued by the Trump administration under which states can get waivers allowing them to use federal funds to subsidize insurance that does not comply with coverage requirements in the Affordable Care Act.

The Democrats’ package includes several measures proposed by freshmen. One, by Representative Angie Craig, Democrat of Minnesota, seeks to lower premiums by setting up reinsurance programs, using a combination of federal and state funds to help pay the largest claims. Minnesota and several other states have established such programs and are pleased with the results.

The package will also include a bipartisan bill offered by Representative Andy Kim, a freshman Democrat from New Jersey, that would provide federal money to states that want to set up their own insurance marketplaces but have yet to do so.

“With skyrocketing premiums in the federal marketplace, state-based exchanges have proven to be more effective at increasing the rate of coverage and lowering costs,” said Representative Brian Fitzpatrick, Republican of Pennsylvania, who helped write this proposal with Mr. Kim.

Democrats in Arizona should seek to reverse Governor Jan Brewer’s wrong-headed decision not to establish a state-based exchange, and allow AHCCCS to run a state-based health insurance exchange. This is the kind of innovation that Obamacare was designed to encourage. This should be the next legislative battle that Democrats wage in Arizona in 2020.

UPDATE: POLITICO reports that the heads of the Justice Department and Health and Human Services Department opposed the unexpected switch in legal tactics. White House Obamacare reversal made over Cabinet objections: Driving the dramatic action were the administration’s domestic policy chief, Joe Grogan, and the acting director of the Office of Management and Budget, Russ Vought, according to three sources with direct knowledge of the decision. Both are close allies of White House acting chief of staff Mick Mulvaney, who helped to engineer the move [and formerly a member of the radical GOP House Freedom Caucus].




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