GOP lawsuit that could bring down Obamacare goes to court

Seeking to do what their peers in Congress couldn't, a coalition of Republican-led states will argue in a US...

Posted: Sep 5, 2018 1:34 PM
Updated: Sep 5, 2018 1:34 PM

Seeking to do what their peers in Congress couldn't, a coalition of Republican-led states will argue in a US District Court in Texas on Wednesday why Obamacare should be declared unconstitutional.

Judge Reed O'Connor will hear oral arguments in the case brought by Texas and 19 other states, which revolves around Congress' reducing the individual mandate penalty to $0, starting in 2019. The states are arguing that this renders the individual mandate -- which requires nearly all Americans to have health insurance -- unconstitutional and that invalidates the entire Affordable Care Act.

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They are asking the judge to block the law immediately and not wait until the case is finally decided.

Notably, the Trump administration will not defend several important provisions of Obamacare in court. However, it is taking a narrower view of the impact of Congress' zeroing out of the penalty, which was included in last year's tax overhaul bill. The Justice Department agrees that the individual mandate is rendered unconstitutional but argues that invalidates only the law's protections of those with pre-existing conditions.

The administration's move has left the defense of the Affordable Care Act to a coalition of 17 other attorneys general, led by California Democrat Xavier Becerra. They argue the mandate remains constitutional and that the rest of the law, in any event, would stand without it. Also, they say eliminating either the Affordable Care Act or the protections for those with pre-existing conditions would harm millions of Americans.

"No one wants to backslide to those bad old days," Becerra told reporters last week.

Consumer protections, pre-existing conditions

The consumer protections targeted by the administration are central to Obamacare and transformed the health insurance landscape.

"Guaranteed issue" requires insurers to offer coverage to everyone regardless of their medical history. Prior to the Affordable Care Act, insurers often rejected applicants who were ill or had pre-existing conditions, or offered them only limited coverage with high rates.

Under the law's community rating provision, insurers are not allowed to set premiums based on a person's health history. And the ban on excluding pre-existing conditions from coverage meant that insurers cannot refuse to pay for treatments because of a policyholder's medical background.

All these provisions, which have proved extremely popular with Americans, meant millions of people who are or have been sick could get comprehensive coverage. But they also have pushed up premiums for those who are young and healthy. This group would have likely been able to get less expensive policies prior to Obamacare that offered fewer benefits.

That has put the measures in the crosshairs of Republicans seeking to repeal the law and lower premiums.

However, their popularity is one of the main reasons GOP lawmakers had such difficulty repealing Obamacare last year and it has given Democrats fodder for attacking Republican rivals in the midterm elections.

Some 52 million adults age 18 to 64 -- or 27% of this population -- have pre-existing conditions that would have led to a denial of coverage in the individual market prior to the Affordable Care Act, according to the Kaiser Family Foundation.

Continuing these protections tops the list of health issues that registered voters say they'll consider in the 2018 campaigns, Kaiser polling found.

A new Kaiser survey, released Wednesday, found that three-quarters of Americans say it's very important insurers remain banned from denying coverage based on people's medical histories. Nearly as many say insurers should continue to be prohibited from charging more because of pre-existing conditions. This includes majorities of Democrats, Republicans and independents.

In a sign of the issue's delicacy, a group of GOP senators recently introduced legislation that they said would maintain some of the protections for those with pre-existing conditions, primarily banning insurers from denying coverage or charging higher premiums based on people's medical histories. Health care experts, however, were quick to point out that the bill would not require insurers to cover treatment of those conditions, which could greatly limit the usefulness of the policies.

If the entire Affordable Care Act were invalidated, the number of uninsured people would increase by more than 17 million, or 50%, according to an Urban Institute report. Many of those losing coverage would be low-income Americans affected by the elimination of the law's Medicaid expansion provision.

The legal arguments

The Republican-led coalition of states is arguing that the Obama administration and a majority of US Supreme Court justices said in prior cases that the mandate is constitutional because its penalty is a tax and the mandate is essential to creating effective health insurance markets.

"The US Supreme Court already admitted that an individual mandate without a tax penalty is unconstitutional," said Texas Attorney General Ken Paxton, when he announced the lawsuit earlier this year. "With no remaining legitimate basis for the law, it is time that Americans are finally free from the stranglehold of Obamacare, once and for all."

Defenders of the law, however, say the court needs only to look at legislators' intent when they voted last year to eliminate the penalty.

"It's perfectly clear that when Congress zeroed out the penalty in 2017, it didn't mean to get rid of pre-existing conditions protections," said Tim Jost, emeritus professor at the Washington and Lee University School of Law.

Mississippi Coronavirus Cases

Data is updated nightly.

Cases: 296154

Reported Deaths: 6764
CountyCasesDeaths
DeSoto19700230
Hinds18851392
Harrison16736281
Rankin12757265
Jackson12623228
Lee9694161
Madison9480203
Jones7990147
Forrest7234138
Lauderdale6837226
Lowndes6032140
Lamar589680
Lafayette5740113
Washington5220130
Bolivar4616124
Oktibbeha441593
Panola431995
Pearl River4178131
Warren4134115
Pontotoc410571
Marshall403592
Monroe3990127
Union396174
Neshoba3817169
Lincoln3552104
Hancock348975
Leflore3380118
Sunflower318986
Tate303174
Pike301296
Scott294570
Alcorn292263
Yazoo290565
Itawamba290175
Coahoma281169
Tippah279265
Copiah278758
Simpson276280
Prentiss270258
Wayne254341
Leake252871
Marion252778
Covington249580
Grenada247878
Adams234678
George232145
Newton230852
Winston221877
Jasper213645
Tishomingo212665
Attala206669
Chickasaw201453
Holmes182370
Clay179251
Stone172429
Tallahatchie171239
Clarke169371
Calhoun158028
Smith153033
Yalobusha145036
Greene127833
Walthall124340
Noxubee122831
Montgomery122639
Perry122135
Lawrence120321
Carroll118625
Amite111734
Webster110832
Jefferson Davis102231
Tunica99323
Claiborne98829
Benton93824
Humphreys92927
Kemper90323
Quitman77414
Franklin76119
Choctaw69817
Jefferson62727
Wilkinson62426
Sharkey49117
Issaquena1676
Unassigned00

Alabama Coronavirus Cases

Cases: 497154

Reported Deaths: 10029
CountyCasesDeaths
Jefferson714001387
Mobile36252736
Madison32573462
Tuscaloosa24289414
Montgomery22708519
Shelby22112215
Baldwin19856285
Lee15021155
Calhoun13755288
Morgan13742252
Etowah13379320
Marshall11439210
Houston10110262
Elmore9451185
Limestone9413136
St. Clair9003225
Cullman8979182
Lauderdale8610212
DeKalb8486175
Talladega7582165
Walker6571259
Jackson6542103
Autauga631391
Blount6229127
Colbert5998120
Coffee5259103
Dale4657107
Russell406433
Franklin399778
Covington3989106
Chilton3891100
Escambia378772
Tallapoosa3613143
Clarke343953
Chambers3423111
Dallas3419142
Pike293372
Marion288895
Lawrence284683
Winston258668
Bibb245960
Geneva240270
Marengo238357
Pickens225055
Barbour212951
Hale211969
Fayette201357
Butler201166
Henry182941
Cherokee177739
Monroe166639
Randolph164640
Washington156635
Macon147243
Crenshaw146254
Clay145554
Cleburne139741
Lamar133733
Lowndes132551
Wilcox122525
Bullock117236
Conecuh107024
Perry105927
Sumter99432
Coosa89624
Greene88532
Choctaw55123
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