Trump takes new jab at Obamacare

U.S. Justice Dept. moves to undercut measures on discrimination and pre-existing conditions

President Trump's Justice Department is working to undercut provisions in the Affordable Care Act on pre-existing conditions and other forms of discrimination. (One Illinois/Ted Cox)

By Mark Guarino

The U.S. Justice Department said Thursday that certain provisions of the Affordable Care Act are unconstitutional, a stance that opens the door for lawmakers to further dismantle the health-care legislation in the years to come.

One of the critical provisions of the ACA, popularly known as Obamacare, is the so-called “individual mandate," which requires that all individuals have health insurance. In a federal brief filed in Texas, the Justice Department said that provision was now unconstitutional following a tax law signed last year by President Donald Trump which eliminated penalties for people without health insurance.

The department also nullified the provision that prevents insurance companies from denying coverage to people with pre-existing conditions and another that prevents insurers from charging different rates based on gender, age, health, or other factors.

Attorney General Jeff Sessions said the individual mandate will become unconstitutional in 2019, the year when Trump’s tax program becomes law. The department weighed in on the matter following a federal lawsuit in Texas by a coalition of 20 states that argued the law — considered the signature achievement of President Barack Obama — was no longer constitutional. Sessions said that his department will no longer defend the provisions.

About 335,000 Illinois residents are enrolled in Obamacare this year, according to a report released in April by the Centers for Medicare & Medicaid Services, a federal agency within the U.S. Department of Health and Human Services. That represents a 6 percent decline from the previous year, and the lowest number since Obamacare became law, which is likely due to efforts by the Trump administration to cut outreach during the enrollment period.

Another cause for the downturn in enrollment is the hike in monthly premiums. Premiums for Illinois residents increased to an average price of $644 a month from $517 the previous year, again partly due to uncertainty about whether the government would sustain the program.

The enrollment drop follows a national trend. This year, 11.8 million signed up for Obamacare, down 3 percent from 12.2 million in 2017.

State Rep. Greg Harris, a Chicago Democrat, said the Trump administration is pushing back protections that have been proven popular over time, especially the provision that abolishes discrimination based on pre-existing conditions. “These [protections] could be gone in a heartbeat and we’ll be back in the bad old days where having anything in your background could lead to exorbitant charges or no insurance at all,” he said.

In late May the state House and Senate passed a bill Harris co-sponsored that would force any Illinois governor to get legislative approval before filing for federal waivers that might reduce health-care benefits for Illinois residents. “We can’t go back to where we have all the higher prices and none of the protections,” Harris said.

U.S. Rep. Jan Schakowsky, of Evanston, called Sessions's position "an atrocity" in a post on Facebook. "The Trump administration and Republicans in Congress have been obsessive and persistent in their cruel campaign to rip health care away from millions of Americans," she said. "Their actions could have devastating consequences for women, people with disabilities, working families, and the 130 million Americans living with pre-existing conditions."

A spokesperson for Gov. Bruce Rauner did not respond to a request for comment. In a statement, Rauner’s Democratic challenger J.B. Pritzker blasted Trump “for pulling the rug out from Americans” who rely on the ACA.

“Eliminating coverage for pre-existing conditions would leave tens of thousands of Illinoisans without any affordable health-care options, forcing them to pay astronomically higher insurance premiums or go without care altogether,” he said. “It is time for Rauner to grow a spine and call out this heartless attack immediately and forcefully. Health care is a right, not a privilege.”

In 2012 the U.S. Supreme Court upheld the individual mandate, arguing that it was authorized by the power of Congress to levy taxes. The repeal of the individual mandate tax under the Trump administration now makes it no longer justified, according to Sessions.

Sessions said that the department will not challenge other provisions of the law, such as subsidies for low-income families and the expansion of the Medicaid program.

This is the latest attempt by the Trump administration to weaken Obamacare since last July after an outright repeal failed in the U.S. Senate. Since then, the administration made different attempts to weaken the legislation. Last fall, it ended a payment to insurers aimed to lower the cost of insurance for low-income people; this year, it worked to loosen rules on short-term health-insurance plans that are considered less expensive because they don’t carry similar protections as the marketplace plans.

California and a coalition of 15 other states filed a motion Thursday to defend the provisions. In a statement, California Attorney General Xavier Becerra called the original Texas lawsuit “dangerous and reckless” because “it would leave millions of Americans without access to affordable, quality health care."

Becerra called it “irresponsible," adding it "puts politics ahead of working families."

The other states involved in the coalition to fight the lawsuit are Illinois, Connecticut, Delaware, Hawaii, Kentucky, Massachusetts, Minnesota, New Jersey, New York, North Carolina, Oregon, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia.

Top Democratic lawmakers released statements late Thursday, criticizing Republicans. House Minority Leader Nancy Pelosi called it a “cynical sabotage campaign” that is taking “Americans’ health care to a stunning new low.” On Twitter, Senate Minority Leader Chuck Schumer said the administration “is allowing premiums to go up and middle class Americans to pay more.”