Trump Administration Presses Court to Strike Down Affordable Care Act

The Trump administration told a federal appeals court Monday night that it believes the entire Affordable Care Act should be struck down as unconstitutional.

In a letter filed in the Fifth Circuit in New Orleans, the Justice Department said it agreed with a December ruling by U.S. District Judge Reed O’Connor in Fort Worth, Texas, that effectively gutted the health care law.

O’Connor held the entire law was invalid based on a December 2017 change to federal tax law that did away with the ACA’s individual mandate penalty.

With the fines gone, he said, the coverage requirement can no longer be considered constitutional, and the entire health care law therefore must be scrapped because it can’t be separated from the coverage requirement.

O’Connor later said the law can stand while his ruling is under appeal.

In its filing in the case on Monday, the Justice Department said it has determined O’Connor came to the correct conclusion and that it will support it on appeal.

The filing came just hours before Democrats on Capitol Hill were set to roll out a wide-ranging package of legislation intended to lower insurance costs and protect individuals with pre-existing conditions, while reversing several steps the White House has taken to weaken it.

“The Republicans did say during the campaign that they weren’t there to undermine the pre-existing condition benefit, and here they are, right now, saying they’re going to strip the whole Affordable Care Act as the law of the land,” House Speaker Nancy Pelosi told reporters Tuesday.

“This is actually an opportunity for us to speak to the American people with clarity,” she continued. “They say one thing and they do another. They say they’re going to protect pre-existing conditions as a benefit, and then they go to court to strip it and strip the whole bill.”

The Democratic bill expands the tax credits available under the law, both reducing costs for lower-income families and expanding eligibility so middle-class Americans can receive federal assistance; creates a national reinsurance program to offset high medical bills for insurers and thereby keep premium increases in check; and rolls back Trump actions that allow for less comprehensive coverage under health insurance plans, give states the freedom to undermine the Affordable Care Acts benefits requirements, and cut enrollment outreach funding.

House Democrats have also asked the Congressional Budget Office for additional information on Medicare buy-ins and single-payer Medicare-for-all, and plan to hold hearings on these issues later this year.

It is rare for the Justice Department to decline to defend a federal law, and in this case its stance is markedly different from the position it took under former Attorney General Jeff Sessions.

Under Sessions, the administration took issue with key provisions of the health care law, including its guarantee of coverage for people with pre-existing conditions, but conceded the rest of the law could stand.

Overturning the law would have far-reaching consequences for millions of people who get their health insurance on the exchanges or through Medicaid expansion.

The Justice Department is expected to expand on its position in a formal brief to the Fifth Circuit in coming days.

Despite the department’s filing and his repeated vows to do away with the Affordable Care Act, President Trump on Tuesday tried to portray he and his fellow Republicans as members of a party focused on health care.

“Let me just tell you exactly what my message is,” Trump told reporters as he visited the Capitol to meet with GOP senators. “The Republican Party will soon be known as the party of health care. You watch.”