WASHINGTON (AP) — As coronavirus cases rise in more than half of the states, the Trump administration is urging the Supreme Court to overturn the Affordable Care Act.
The administration’s high court filing at 10:30 p.m. Thursday came the same day the government reported that close to half a million people who lost their health insurance amid the economic shutdown to slow the spread of COVID-19 have gotten coverage through HealthCare.gov.
The administration’s legal brief makes no mention of the virus.
More than 20 million Americans could lose their health coverage and protections for people with preexisting health conditions also would be put at risk if the court agrees with the administration. Nothing will happen immediately. The case won’t be heard before the fall.
House Speaker Nancy Pelosi blasted the administration’s latest move in a partisan battle over “Obamacare” that has stretched on for a full decade since the law’s passage in 2010. Pelosi is planning a floor vote early next week on her own bill to expand the ACA, sweetening its health insurance subsidies so more people will be covered.
“There is no legal justification and no moral excuse for the Trump administration’s disastrous efforts to take away Americans’ health care,” she said in a statement.
Just as the nation seemed to be getting better control over the virus outbreak, states including Arizona, California, Florida, Georgia, Nevada and Texas are reporting a surge in cases. Overall, more than half the states are seeing case increases and some are tapping the brakes on reopening plans.
Anger over problems with “Obamacare” was once a winning issue for Republicans, helping them gain control of the House in 2010 and the Senate in 2014. But the politics of the issue flipped after President Donald Trump failed to deliver in 2017 on his vow to “repeal and replace” the health law and provide lower-cost coverage for everybody. Democrats were energized by their successful defense of the ACA, and that contributed to their winning back the House.
In the case before the Supreme Court, Texas and other conservative-led states argue that the ACA was essentially rendered unconstitutional after Congress passed tax legislation in 2017 that eliminated the law’s unpopular fines for not having health insurance, but left in place its requirement that virtually all Americans have coverage.
Trump has put the weight of his administration behind the legal challenge.
If the health insurance requirement is invalidated, “then it necessarily follows that the rest of the ACA must also fall,” Solicitor General Noel Francisco wrote Thursday. It’s the third time the court is being asked to undo “Obamacare.” Two previous attempts failed.
At the White House on Friday, there was no turning back.
“A global pandemic does not change what Americans know — Obamacare has been an unlawful failure,” White House spokesman Judd Deere said Friday in a statement. He said it limits choice and “forces Americans to purchase unaffordable plans.”
Other prominent Republicans, including Sen. Lamar Alexander of Tennessee, have said Congress didn’t intend to bring down the whole law by striking the coverage penalty.
Alexander, who leads the Health, Education, Labor and Pensions committee, has repeatedly said there’s no way Congress would repeal protections for people with preexisting conditions. He says senators intended to repeal the penalty for people who go without coverage, and that’s all.
The Trump administration’s views on what parts of the ACA might be kept or replaced if the law is overturned have shifted over time. But in legal arguments, it has always supported getting rid of “Obamacare” provisions that prohibit insurance companies from discriminating against people on account of their medical history.
Nonetheless, Trump has repeatedly assured Americans that people with preexisting conditions would still be protected. Neither the White House nor congressional Republicans have specified how.
The government report showing rising sign-ups for health coverage under the ACA amid the coronavirus shutdown came from the Centers for Medicare and Medicaid Services. The figures are partial because they don’t include sign-ups from states that run their own health insurance marketplaces. Major states like California and New York are not counted in the federal statistics.
An estimated 27 million people may have lost job-based coverage due to layoffs. That means they would be eligible for a special sign-up period for subsidized plans under the Obama-era law. Many may also qualify for Medicaid.
Thursday’s report from the government showed that about 487,000 people signed up with HealthCare.gov after losing their workplace insurance this year. That’s an increase of 46% from the same time period last year.
It’s unclear from the government numbers how many of the new enrollees lost their coverage because of layoffs due to the pandemic. CMS also made no estimate of how many people will ultimately seek coverage through the Obama health law as a result of economic shock waves. Generally there’s a 60-day window to apply after losing coverage.
However, the report found a clear connection. “While the magnitude may be unclear, job losses due to COVID-19 have led to increased enrollments on HealthCare.gov,” it said.
Q&A: Overturning ‘Obamacare’ during a pandemic
WASHINGTON (AP) — The decade-old health care law that has divided Americans even as it expanded coverage and protected people with preexisting conditions is being put to yet another test. Amid a pandemic, President Donald Trump and some red states want the Supreme Court to declare the Affordable Care Act unconstitutional. Blue states and the U.S. House say the case has no merit.
Here are questions and answers as the case unfolds:
WHAT HAPPENS NOW?
In the real world, very little will change right away. Politically, it’s another story.
It’s unclear if the court will hear oral arguments before the November election. A decision isn’t likely until next year, which means the ACA stays in place for the foreseeable future.
Even if a Supreme Court majority comes down of the side of “Obamacare’s” opponents, unwinding the 10-year-old law would be time-consuming and fraught with political risk. Many of the ACA’s provisions are popular, such as guaranteed coverage for people with preexisting medical conditions, and birth control coverage for women free of charge. Others are wired into the health care system, like changes to Medicare payments and enhanced legal authority against fraud.
In the political realm, Trump’s unrelenting opposition to the ACA energizes Democrats going into the November elections.
As if on cue, House Speaker Nancy Pelosi has rolled out a bill to expand the health law, and the House is expected to vote on it Monday.
The goal isn’t so much to pass legislation, since Pelosi’s bill won’t get a look in the Republican-controlled Senate. But it may make some Republicans squirm by forcing them to cast a vote their Democratic opponents can use in campaign ads this fall.
“God willing the courts will do the right thing, but we just don’t know,” says Pelosi. “So we are getting prepared for what comes next.”
HOW IS OBAMACARE DOING UNDER TRUMP?
Remarkably well, despite dramatic pronouncements by politicians on both sides.
Larry Levitt of the nonpartisan Kaiser Family Foundation estimates that about 23 million people are covered under the law, about the same as when former President Barack Obama left office.
That includes about 12.5 million covered under Medicaid expansions in most states and some 10 million through health insurance marketplaces like HealthCare.gov that offer individual plans subsidized by the taxpayers.
According to Gallup, Americans under Trump have either tilted in favor of the ACA or been closely split. By contrast, during Obama’s last term, the public more often tilted against the law. Fifty-two percent approved of the ACA in March, while 47% disapproved.
A turning point came when Trump and a GOP Congress failed to repeal Obamacare in 2017.
DOES THE ACA MAKE ANY DIFFERENCE IN THE COVID-19 PANDEMIC?
It has taken on a new role. Coverage through the ACA can be a lifeline for people who lost their health insurance as a result of layoffs.
The Kaiser Family Foundation estimated recently that nearly 27 million people lost employer coverage because of pandemic-related layoffs, and nearly 80% would be eligible for Medicaid or an Obamacare plan with subsidized premiums.
New government numbers show HealthCare.gov enrollment has grown by about half a million people amid the pandemic.
WHAT WOULD HAPPEN TO PROTECTIONS FOR PEOPLE WITH PREEXISTING CONDITIONS?
That’s a source of anxiety for many Americans.
A Kaiser foundation poll in January found that 57% are worried that they or someone in their family will lose health insurance if the Supreme Court overturns the ACA’s protections for people with preexisting conditions. Under Obamacare, insurers cannot use someone’s medical history to turn them away or charge them more.
The Trump administration has argued in court that the law’s constitutional flaws would also entangle its protections for people with preexisting conditions.
Yet Trump has promised he would preserve those safeguards, without laying out a plan for how he would do that.
Some prominent Republicans say they never intended to undermine protections for people with preexisting conditions when they voted to repeal Obamacare’s unpopular fines on people going uninsured. That repeal is the root cause of the current court case, since the law’s opponents argue that without the fines the entire statute is rendered unconstitutional.
Traditionally, Republicans have supported protections for people with preexisting conditions, but with a limitation that individuals have to keep up their coverage to qualify.
WHERE’S JOE BIDEN IN ALL OF THIS?
He’s backing his former boss’ signature legislation.
The Democratic presidential candidate says if elected president he would build on the ACA to move the nation closer to coverage for all. Biden would increase the health law’s subsidies for individual private plans, finish its Medicaid expansion, and create a new “public option” alternative modeled on Medicare.
HOW IS THE U.S. DOING ON ACCESS TO HEALTH INSURANCE?
Under Trump, the uninsured rate had started inching up again. The economic shutdown to try to slow the spread of coronavirus is likely to have made things much worse, but government numbers aren’t available to quantify the impact.
The Census Bureau reported last year that 27.5 million people, 8.5% of the population, lacked health insurance coverage in 2018. That was an increase of 1.9 million uninsured, or 0.5 percentage point, from 2017.
It’s not clear how many people who lost employer coverage in the pandemic have wound up uninsured.