WASHINGTON – The Trump administration broadened its attack on the Affordable Care Act on Monday, counting a federal appeals court that now believed the entire law should be invalidated.
The administration had previously said that the law's protections for people with Pre-existing conditions should be down, but the rest of the law, including the expansion of Medicaid, should survive.
If the appeals court accepts the Trump administration's new arguments, millions of people could lose health insurance, including those who gained coverage through the expansion of Medicaid and those who have private coverage subsidized by the federal government.
The Justice Department released its new stance in a two-sentence letter to the United States Court of Appeals for the Fifth Circuit, in New Orleans, will elaborate on its position in a letter to be filed later.
In the letter, the Justice Department said the court should affirm a judgment issued in December by Judge Reed O'Connor of the Federal District Court in Fort Worth
Judge O'Connor, in a sweeping opinion, said that the individual mandate requiring people to have health insurance "can no longer be sustained as an exercise of Congress's tax power" Because Congress has eliminated the tax penalty for people who go without health insurance,
Judge O'Connor said, "The individual mandate is unconstitutional" and the remaining provisions of the Affordable Care Act is also invalid
In its letter to the Appeal Court, the Justice Department said on Monday that it is "not urging any portion of the district court's judgment to be reversed." O'Connor's ruling
In the nine years since it was signed by President Barack Obama, the Affordable Care Act has become embedded in the nation's health care system. It changed the way Medicare pays doctors, hospitals and other health care providers. It has unleashed a tidal wave of innovation in the delivery of health care. The health insurance industry has invented a new business model covering anyone who applies, regardless of any pre-existing conditions.
The law also includes dozens of provisions that are less well-known and not related to the individual mandate. It requires nutrition labeling and calorie counts on menu items at chain restaurants. It requires certain employers to provide “reasonable break time” and a private space for nursing mothers to pump breast milk. The improved prescription drug coverage for Medicare beneficiaries, and the created a new pathway for the approval of less expensive versions of biologic medicines made from living cells
Lawyers said invalidation of the entire law would raise numerous legal and practical questions. It is difficult to imagine what the health care world would look like without the Affordable Care Act.
The Trump administration's new position was critically criticized by the insurance industry and by consumer advocates.
The government's position " said Matt Eyles, president and chief executive of America's Health Insurance Plans.
Leslie Dach, chairman of Protect Our Care, a consumer advocacy group, said: "In November , voters overwhelmingly rejected President Trump's health care repeal and sabotage agenda. But it remains dead set on accomplishing through the courts what he and his allies in Congress could not be legislatively: completely repeal the law, devastate American health care and leave millions of Americans at risk. ”The Trump administration's new stance appears to be put Republicans in Congress in an awkward position. They have repeatedly tried to repeal the health law. But in the last year, they said about and about that they wanted to protect coverage for people with pre-existing conditions, and those protections are among the most popular provisions.
The lawsuit challenging the Affordable Care Act, Texas v. United States, was filed last year at a group of Republican governors and state attorneys general. Officials from California and more than dozen other states have intervened to defend the law.
The Texas lawsuit "is dangerous when it is reckless," Xavier Becerra, the attorney general of California, said on Monday as he filed a letter urging the law court to uphold the law.