Trump Administration Asks Supreme Court to Strike Down Affordable Care Act
Source: The New York Times, by Sheryl Gay Stolberg
The Trump administration asked the Supreme Court late Thursday to overturn the Affordable Care Act — a move that, if successful, would bring a permanent end to the health insurance program popularly known as Obamacare and wipe out coverage for as many as 23 million Americans.
In an 82-page brief submitted an hour before a midnight deadline, the administration joined Republican officials in Texas and 17 other states in arguing that in 2017, Congress, then controlled by Republicans, had rendered the law unconstitutional when it zeroed out the tax penalty for not buying insurance — the so-called individual mandate.
The administration’s argument, coming in the thick of an election season — as well as a pandemic that has devastated the economy and left millions of unemployed Americans without health coverage — is sure to reignite Washington’s bitter political debate over health care.
In his brief, Solicitor General Noel J. Francisco argued that the health law’s two remaining central provisions are now invalid because Congress intended that all three work together.
“Nothing the 2017 Congress did demonstrates it would have intended the rest of the A.C.A. to continue to operate in the absence of these three integral provisions,” the brief said, using the abbreviation for the name of the health care law. “The entire A.C.A. thus must fall with the individual mandate.”
The Texas case is by far the most serious challenge to date for the 10-year-old health care law, President Barack Obama’s signature domestic achievement. The Supreme Court has already ruled on two legal challenges to the act, and both times it has left most of the law in place.
The court has not said when it will hear oral arguments, but they are most likely to take place in the fall, just as Americans are preparing to go to the polls in November.
Republicans have long said their goal is to “repeal and replace” the Affordable Care Act but have yet to agree on an alternative. They are bracing for the possibility that the effort to overturn the health law will cost them. Joel White, a Republican strategist, said in a recent interview that he considered it “pretty dumb to be talking about how we need to repeal Obamacare in the middle of a pandemic.”
Democrats, who view health care a winning issue and who reclaimed the House majority in 2018 on their promise to expand access and bring down costs, are trying to use the Supreme Court case to press their advantage. Speaker Nancy Pelosi has scheduled a vote for Monday on a measure to expand the health care law, in an effort to draw a sharp contrast between Democrats and Republicans.
“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,” Ms. Pelosi said in a statement late Thursday night, after the administration’s brief was filed.
“If President Trump gets his way,” she added, “130 million Americans with pre-existing conditions will lose the A.C.A.’s lifesaving protections and 23 million Americans will lose their health coverage entirely.”
The case the court will hear grows out of a lawsuit that Republican officials in 20 states, led by Texas, filed against the Department of Health and Human Services in February 2018, seeking to have the health law struck down. After Democratic victories in the 2018 midterm elections, two states, Wisconsin and Maine, withdrew.
When the case was argued in the trial court, the Trump administration, though a defendant, did not defend the law, siding instead with the plaintiffs. But unlike Texas and the other states, the administration argued at the time that only the law’s protections for people with pre-existing conditions should be struck down, but that the rest of the law, including its expansion of Medicaid, should survive.
Last year, however, the administration expanded its opposition, telling a federal appeals court that the entire law should be invalidated. In the meantime, another 17 states, led by California, intervened to defend the law, as did the House, now controlled by Democrats.
“Now is not the time to rip away our best tool to address very real and very deadly health disparities in our communities,” Attorney General Xavier Becerra of California said in a statement on Thursday, adding: “This fight comes at the most crucial time. The death toll from the coronavirus today is greater than the death toll of the Vietnam War.”
The Supreme Court has agreed to consider three legal questions in the case: whether Texas and two individual plaintiffs who have joined the suit have standing; whether Congress rendered the individual mandate unconstitutional; and, if it did, whether the rest of the law must fall with it.
If the court strikes down only the mandate, not much will change, according to an analysis by the Kaiser Family Foundation, which wrote that the “practical result will be essentially the same as the A.C.A. exists today, without an enforceable mandate.” But if the court decides that all or part of the law must be overturned, it would affect “nearly every American in some way,” the foundation wrote.
The Texas suit has created great uncertainty for the roughly 20 million people covered by the law, as well as for millions of others who have lost their jobs and health coverage during the coronavirus pandemic. A recent analysis by the liberal-leaning Center for American Progress estimated that 23 million people would lose coverage if the Affordable Care Act is abolished — including nearly two million in Texas and more than four million in California.
The lawsuit has also drawn opposition from hospitals and doctors, including the American Medical Association. In a friend of the court brief filed last month, it wrote that striking down the law “at a time when the system is struggling to respond to a pandemic that has infected nearly 1.4 million Americans and killed more than 80,000 at the time of this writing would be a self-inflicted wound that could take decades to heal.”