The Health Care Stalkers
These benighted moves come at a time when voters everywhere rank health care as their chief concern, and a majority say they favor fixing the current law over repealing it, after years of futile Republican efforts to do the latter.
The lawsuit, filed in February, hinges on the statute's "individual mandate," which requires everyone — the healthy and the less so — to buy insurance as a way to help keep prices down. In 2012 the Supreme Court ruled that Congress couldn't order people to buy coverage but could impose a tax penalty on those who didn't. Then, in last year's tax bill, Congress eliminated the financial penalty. Without the penalty, the plaintiffs argue, the mandate is no longer constitutional. And without the mandate, they say, the rest of the law can no longer legally stand.
The Justice Department last week stopped short of fully agreeing with that rationale, saying that some of the law's provisions, like the Medicaid expansion that brought coverage to nearly 12 million low-income Americans, could stand without the penalty, but that the court should strike down key consumer protections at the law's core.
Such protections prohibit insurers from denying coverage to people with pre-existing medical conditions or from charging such people more for coverage. The rules, which protect some 52 million Americans, according to a Kaiser Family Foundation analysis, are far and away the law's most popular features; a 2016 poll by the same organization found that 75 percent of Democrats and 63 percent of Republicans support them. But, in a letter to the House speaker, Paul Ryan, Attorney General Jeff Sessions said his department could think of no rational argument with which to defend them.
They're not thinking hard enough. Sessions would do well to read the legal filings of 16 Democratic state attorneys general who have stepped in to do his job for him. Led by Xavier Becerra of California, they make a persuasive case, echoing sentiments expressed by legal observers on both sides, that the suit is absurd.
Sessions' supporters have compared his stance to the Obama administration's refusal to defend the Defense of Marriage Act in 2011. But the two aren't equivalent. Challenges to the marriage law raised fundamental questions about who we are as a people, and what we want the Constitution to stand for. The Justice Department made the case, later accepted by the Supreme Court, that American society had evolved to the point where denying federally protected marriage rights to same-sex couples was discriminatory and therefore unconstitutional.
The Affordable Care Act, by contrast, has withstood numerous legal challenges in the eight years since it became law, including two at the Supreme Court. The current lawsuit against it hinges not on big questions of equality and justice, but on a technicality.
If that technicality were to carry the day, insurance companies could once again deny coverage, or charge much more for it, to people who have battled cancer, or are pregnant, or who have diabetes, or a heart condition, or arthritis. There's no clear-cut definition of "pre-existing condition," so this list goes on and on, affecting Americans of all political stripes. And even if the current law prevails in court, at least some damage will already have been done; uncertainty created by the Justice Department's stance will almost certainly lead to higher premiums for Americans.
Add this latest move to a growing list of similar efforts — eliminating the mandate tax penalty to begin with, allowing more short-term plans on the market — and it becomes clear where the administration's priorities lie: not in helping more Americans get good health care, not even in supporting the will of the people, but in dismantling what some political opponents built, just for the sake of doing so.
— New York Times
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