Trump Administration, Republican Attorneys General Ask Supreme Court to Repeal ACA

American Journal of Medicine -- PRESS Release June 25, 2020 by Gianna Melillo: The Trump administration and Republican state attorneys general called on the Supreme Court to overturn the entire Affordable Care Act (ACA, also known as Obamacare).

President Trump has endorsed repealing the ACA since his 2016 campain, while Republican lawmakers have largely opposed the law since its inception in 2010.

This story has been updated.

The Trump administration yesterday asked the Supreme Court to repeal the Affordable Care Act (ACA, also known as Obamacare) stating "the entire ACA act must fall," hours after Republican state attorneys general, the coalition challenging the law, filed its briefs in the case. Overturning the ACA was a key campaign rallying point for President Trump in 2016 and Republican lawmakers have largely opposed the law since its inception in 2010.

Despite the economic crisis due to the coronavirus disease 2019 (COVID-19) pandemic, Trump in May promised to continue fighting the ACA, stating “We want to terminate health care under Obamacare.” The case is expected to go before the Supreme Court in the spring of 2021.

In a statement, House Speaker Nancy Pelosi (D-CA) condemned the request. "“President Trump and the Republicans’ campaign to rip away the protections and benefits of the Affordable Care Act in the middle of the coronavirus crisis is an act of unfathomable cruelty," she stated. 

In 2017, Trump eliminated the individual mandate—the heart of the ACA that requires everyone to have health coverage and lays the groundwork for a risk pool that is more balanced between the sick and the healthy and the young and the old. Subsequently, in 2019 the Fifth Circuit of the United States Court of Appeals ruled the mandate unconstitutional.

The filing accuses the ACA of inflicting “classic pocketbook injuries on the states,” in addition to preventing states from enforcing their own laws and policies.

“Congress deliberately designed the ACA and its goal of expanding healthcare coverage around the individual mandate,” the brief reads. “Without the mandate, the guaranteed-issue and community-rating provisions not only malfunction but result in the opposite of what Congress intended.” The filing urges the Supreme Court to affirm the statutory text deeming the individual mandate essential.

Attorney General Ken Paxton of Texas filed the brief along with 17 attorneys general from Alabama, Arizona, Florida, and other states. “Congress declared in the text of the law that the individual mandate is the centerpiece of Obamacare. Without the unlawful mandate, the rest of the law cannot stand,” Paxton said in a statement. “Obamacare has failed, and the sooner it is invalidated, the sooner each state can decide what type of health care system will best provide for those with preexisting conditions, which is the way the Founders intended.” 

The move has been met with fierce opposition, particularly from those who decry reducing insurance coverage in the middle of a pandemic. In response to the impending briefs, House Democrats yesterday unveiled legislation intended to boost the ACA.

The Patient Protection and Affordable Care Enhancement Act aims to expand access to health care, lower Americans’ health coverage costs, negotiate lower prescription drug prices, and incentivize holdout states to adopt Medicaid expansion.

“It’s commonsense legislation that takes the savings from lower prescription drug costs and invests it into lowering health care premiums and expanding access to affordable care,” said Health Committee Chairman Frank Pallone Jr, D-New Jersey, in a statement. “All around, that’s a win for the American people. We must take action to lower these soaring costs, expand access to health care, rein in the Trump Administration’s efforts to sabotage the ACA and protect people with pre-existing conditions.”

An analysis released by CMS yesterday found during April and May 2020, more individuals took advantage of the special enrollment period (SEP) on to gain coverage compared with the same time period in 2019. "By month, the largest gain in loss of minimum essential coverage SEP enrollments occurred in April 2020, with enrollments increasing by 139% when compared to April 2019," the report reads. 

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