WASHINGTON - The US Justice Department on Thursday said the part of Affordable Care Act requiring people to have health insurance is unconstitutional, an unusual move that could lead to stripping away some of the most significant and popular parts of the law, better known as Obamacare.
Plans have requested a 24% rate increase on average for 2019, with about half that amount tied to the elimination of the individual mandate. It helped expand their risk pools while the law forced them to guarantee coverage to any customer.
"You've got very sympathetic populations that are affected by those conditions so to somehow adversely affect them is not a politically wise move", said Representative Tom Reed, a New York Republican, signaling opposition to the administration's decision.
The decision, announced in a filing late Thursday in a federal court in Texas, is a rare departure from the Justice Department's practice of defending federal laws in court.
In a brief filed in a federal court in Texas, the department said a tax law signed a year ago by President Donald Trump that eliminated penalties for not having health insurance rendered the so-called individual mandate under Obamacare unconstitutional. But past year the Republican-controlled Congress eliminated those penalties as part of the $1.5 trillion tax overhaul that Trump signed in December. That ruling hinged on the reasoning that, while the government "does not have the power to order people to buy health insurance", as Chief Justice John Roberts wrote for the majority, it "does have the power to impose a tax on those without health insurance".
"The decision by the Department of Justice to abandon critical patient protections is devastating for the millions of Americans who suffer from serious illnesses or have pre-existing conditions and rely on those protections under current law to obtain life-saving health care", wrote a coalition of patient advocacy groups, including the American Cancer Society and the American Heart Association.
As many as 130 million adults under age 65 in the US have pre-existing conditions that could result in their not being able to get insurance coverage in the private market, according to the Department of Health and Human Services. The Justice Department seeks a declaratory judgment that those provisions will be invalid as of January 1.
SIMON: How might this change how individual people are covered and treated in this country?
Republicans seem determined not only to make American health care more inefficient and cruel in every way they can think of, but to do it while making themselves as unpopular as possible.
The same report estimates 391,000 Utahns have pre-existing conditions that could affect their coverage eligibility.
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"I am at a loss for words to explain how big of a deal this is", University of MI law professor Nicholas Bagley said in a blog post.
The two provisions, along with Obamacare's requirement that insurers offer comprehensive coverage, have been targets of Republicans seeking to repeal the law and lower premiums.
The provisions DOJ says should be invalidated are central to the ACA and would gut protections for those with pre-existing conditions. It will also make it more likely that they take back the White House in two years. Not only may health insurance continue getting less affordable, they even want to take away the pre-existing conditions protection you now enjoy, all while they're working hard to destabilize the private insurance market.
But others say the legal brief may have minimal impact next year on premiums.
Some critics of the administration's decision said California should go forward with enacting its own mandate for individual coverage, as a few other states have done.
A bigger effect on premiums, according to both Corlette and Laszewski, are factors already in play that are expected to draw younger and healthier people out of the ACA marketplace. With the repeal of the mandate penalty, the mandate became a simple requirement to buy a service-not a tax-and is therefore not constitutional.
The Supreme Court is considering some of the issues this term. Now his administration is walking back on that promise in a major way.
Lawmakers said they still are reading a Thursday court filing that is reviving the health care reform debate in a pivotal midterm year.
NY was one of 17 states to intervene in the case in May in defense of the ACA.
Other legal observers point out that's not how the lawmaking process works.
The Department in the past has declined to defend a statute in cases in which the President has concluded that the statute is unconstitutional and made manifest that it should not be defended, as is the case here.See Seth P. Waxman, Defending Congress, 79 N.C. L.Rev. 1073, 1083 (2001).The 2012 SCOTUS ruling precludes any claim that Congress had the authority to impose the mandate pursuant to its powers under the Commerce Clause.