Just when you thought the results of the November 2018 election shellacking taught the Trump Administration and Republican Party a lesson on the perils of attacking the Affordable Care Act (ACA) and jeopardizing tens of millions of Americans’ health insurance coverage, here they come again.
Except, this time they may accomplish in the courts what they could not achieve in the legislature.
To the surprise of nearly everyone, the Trump Administration’s Department of Justice recently gave its full backing to efforts to invalidate the entire Affordable Care Act, including provisions prohibiting the discrimination of patients based upon pre-existing conditions.
The Washington Post reports that in a legal filing late March with the U.S. Court of Appeals for the 5th Circuit Court in New Orleans, DOJ officials told the court it supported the position of a December federal District Court ruling from Texas that declared the law unconstitutional. That court determined the ACA’s individual mandate “can no longer be sustained as an exercise of Congress’s tax power” and further found that the remaining portions of the law are void.
“The Department of Justice has determined that the District Court’s comprehensive opinion came to the correct conclusion and will support it on appeal,” Kerri Kupec, a spokeswoman for the Justice Department, said in a statement.
That means if the Appellate Court upholds the sweeping condemnation from the lower court, the entire ACA, also known as Obamacare, will be rendered null and void. And neither the Trump Administration nor Republican Party has offered an alternative or even meaningful modifications to keep even the framework of the plan in place.
Local health policy experts claim the effect of losing the ACA would be devastating for the 21 million Americans who rely on it for their health care. That includes the roughly one million Michigan residents who are enrolled in the state’s Healthy Michigan program which is funded through the ACA.
Marianne Udow-Phillips, the executive director of the Center for Health and Research Transformation at U-M, said in a statement that if the Texas District Court’s decision that determined that the entire Affordable Care Act is unconstitutional is upheld, far more than the individual marketplace plans and the Medicaid expansion would be disrupted in Michigan:
“Nine years in, the ACA is fully woven into our health system and beyond. It is because of the ACA that chain restaurants are required to list calorie counts; it is because of the ACA that most employers must provide a lactation room for breastfeeding employees; it is because of the ACA that youth up to age 26 can stay on their parents’ health insurance plans; and, it is because of the
ACA that hospitals, physicians and other providers across Michigan (and the country) are participating in new ways to deliver and finance health, such as Accountable Care Organizations that earned hospitals in Michigan $71.6 million and saved Medicare $181.6 million in 2017 alone. It is hard to overstate the amount of disruption that would occur in our health care fabric if this decision stands.”
U.S. Senator Debbie Stabenow (D-MI) said in a statement that the Texas ruling must be overturned.
“This outrageous ruling threatens health coverage for millions of Americans. If you have a pre-existing condition, you could be denied insurance or have to pay more for your coverage. Without the federal tax credits, insurance would become unaffordable for many Americans and being a woman could once again be considered a pre-existing condition. Mental health services and affordable medicine would be put at risk. And Healthy Michigan, which covers one million Michiganders, would be gone! This ruling must be overturned.”
Gilda Jacobs, president, and CEO of the Michigan League for Public Policy agreed and said the economic ripple and humanitarian effect of such a crisis may overwhelm our state.
“To say we are going to do this repeal without anything in place is just reckless,” she said. “People need to feel secure. They need to know and be able to get the health care that they need.”
Jacobs noted during the last election many Republican candidates even made support of health care – including support for a policy that protected people with pre-existing conditions a focal point of their campaigns.
“I just don’t understand the rationale from a practical or political standpoint,” she said.