High Stakes Legal Gambit Threatens Health Care for Millions

Alicia Farmer
September 6, 2018

The states are arguing that this renders the individual mandate - which requires almost all Americans to have health insurance - unconstitutional and that invalidates the entire Affordable Care Act.

There even has been speculation by many opponents of his confirmation that, because of his dissent in the 2011 appeal to his U.S. Court of Appeals District Circuit Court (he felt the court had no jurisdiction to rule on a tax that hadn't yet been collected), this somehow means he would rule the law to be unconstitutional without the individual mandate.

The Trump administration earlier this year elected not to defend the law, an unusual departure from the Justice Department's traditional responsibility to safeguard federal law.

Chief Justice John G. Roberts Jr. joined the court's four liberal justices to uphold the law, but only after concluding that the requirement could stand because it was enforced with a tax penalty.

Undoubtedly, the Texas lawsuit could have important and deleterious consequences for people with pre-existing conditions, and it appears that the proposed Republican bill, which has not yet been voted on, may do little to actually ensure people receive the health care they need.

It's also no surprise that so many are anxious about a current lawsuit being brought in Texas by 20 Republican-controlled states; it contends that because the individual mandate tax has been removed, the entire ACA law is unconstitutional and therefore null and void.

Rates will decreased by an average of 6 percent under Molina Health Care, remain unchanged under Blue Cross and Blue Shield, and increase by 4 percent under Christus Health Plan, according to state insurance regulators. But Republicans in particular, while they mostly oppose the health law, are aware that the provisions protecting people with preexisting conditions are by far the most popular part of the ACA.

In a sign of the issue's delicacy, a group of GOP senators recently introduced legislation that they said would maintain some of the protections for those with pre-existing conditions, primarily banning insurers from denying coverage or charging higher premiums based on people's medical histories.

These protections are among the most popular parts of the health care law.

"This case is going to help renew the focus on health care in the midterm elections", said Celinda Lake, a longtime Democratic pollster, who noted that the issue had been flagging slightly as President Donald Trump and other Republicans have talked less about rolling back the health care law since they failed to repeal it in Congress previous year.

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In the meantime, open enrollment on the ACA exchanges is set to begin on November 1, with the Trump administration once again providing reduced funding for outreach groups that help people enroll.

The Democratic attorneys general applied to "intervene" in the case to defend the law in its entirety.

Continuing these protections tops the list of health issues that registered voters say they'll consider in the 2018 campaigns, Kaiser polling found. The plaintiffs are asking the court for an immediate injunction that would effectively throw out the entire ACA.

The State of Texas has filed multiple lawsuits against the law, also known as Obamacare.

Texas Republicans have spearheaded a nationwide effort to kill the Affordable Care Act with a sweeping lawsuit that aims to overhaul maybe the biggest legislative accomplishment of the Obama administration.

"All it takes is for a district court judge and then an appellate panel to find some validity in the argument for it to get up to the Supreme Court", he added.

However, their popularity is one of the main reasons GOP lawmakers had such difficulty repealing Obamacare past year and it has given Democrats fodder for attacking Republican rivals in the midterm elections.

As a "fallback position", plaintiffs also made a case for ending protections for people with pre-existing conditions in the 20 states involved in the case by 2019.

Marlene Baca, CEO of the nonprofit on-exchange insurance provider New Mexico Health Connections, said Wednesday that the cooperative has focused on its management of medical costs in the wake of recent regulatory upheaval.

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