The Trump administration filed a notice March 25 supporting a federal judge’s ruling that the Affordable Care Act should be thrown out in its entirety—a sharp pivot from the administration’s previous position that only parts of the law should be eradicated.
U.S. District Court Judge Reed O’Connor of Texas ruled the ACA unconstitutional in its entirety last December, remarking “the Individual Mandate is so interwoven with (the ACA’s) regulations that they cannot be separated.” The Justice Department initially said there were only grounds to strike down the ACA’s consumer protections—including those for patients with preexisting conditions—but its latest filing suggests it now supports a full invalidation of the law.
The House of Representatives filed a brief in the U.S. Fifth Circuit Court of Appeals shortly after the Justice Department backed O’Connor’s ruling, warning an ACA repeal would throw the U.S. health system into “chaos.”
“The severity of such consequences calls for the utmost caution, and plaintiffs’ arguments do not come close to justifying such massive harm,” the brief read.
The House argued that an overturn of Obamacare would result in millions of Americans without access to affordable healthcare, sky-high insurance premiums and price hikes for drugs and medical services. The ACA’s preexisting conditions provision alone affects more than 100 million people.
“On the very first day that the Democratic majority held the gavel, the House of Representatives voted to intervene against Republicans’ monstrous healthcare lawsuit to defend people with preexisting conditions and the healthcare of all Americans,” House Speaker Nancy Pelosi said in a statement, calling the Trump administration’s latest move a declaration of “all-out war on the health of the American people.”
“While the Trump Administration broadens its monstrous ambitions from destroying protections for preexisting conditions to tearing down every last benefit and protection the Affordable Care Act provides, Democrats are fiercely defending the law of the land and protecting all Americans’ healthcare.”
President Trump himself was decidedly more optimistic, tweeting on March 26, “The Republican Party will become ‘The Party of Healthcare!’” His administration’s decision to support O’Connor’s judgement throws healthcare back into the center of the 2020 election.
“I don’t really know why they would do this now,” Alison Kodjak, a health correspondent for NPR, said on Morning Edition March 26. “What became clear during the midterms was that the Affordable Care Act became pretty popular among voters. ... So politically, trying to take this law away and really upend the whole healthcare system could be pretty tricky and dangerous politically for the Trump administration and for Republicans who support this legal case.”
Republicans are seeking to overturn the ACA without a replacement, and, according to the New York Times, a comprehensive health plan would be unaffordable for most Americans without the marketplaces and subsidies provided by Obamacare. States would be unable to replace the full amount of federal subsidies with state funds, putting 12 million adults in jeopardy of losing their Medicaid coverage, leaving 60 million Medicare beneficiaries with higher premiums and throwing the future of 2 million dependents’ healthcare into question.
“Really, this law touches every part of the healthcare system,” Kodjak said. “It determines how Medicare pays doctors. It creates this Medicaid expansion, which many states have taken on, which has covered millions of lower-income people. It determines things like whether restaurants have to post nutrition information. ... It really touches everything.”