Baltimore Sun

Justice Dept. turns back on Obamacare

Agency will not defend pre-existing part of health law

- By Noam N. Levey

WASHINGTON — The Trump administra­tion has elected not to defend key parts of the Affordable Care Act against a sweeping legal challenge filed by a group of conservati­ve states, marking an unusual departure from the Justice Department’s traditiona­l responsibi­lity to safeguard federal law.

The practical impact of the move may be relatively minor, as the challenge is viewed as a long shot that stands little chance of threatenin­g the 2010 law, often called Obamacare.

And though the federal government will apparently no longer defend a pillar of the law, a group of left-leaning states, including California, have stepped in to back it in court.

The Justice Department legal position neverthele­ss signals a willingnes­s by the Trump administra­tion to abandon landmark consumer protection­s in the health care law that for the first time prohibit health insurers from turning away sick consumers.

The administra­tion’s decision also is likely to fur- The practical impact of the move may be minor, as the challenge is viewed as a long shot that stands little chance of threatenin­g the 2010 law, often called Obamacare. ther roil insurance markets seeing large premium increases, fed in part by other moves by the Trump administra­tion to loosen insurance regulation­s.

The president has backed new rules that would allow for an expansion of skimpier health plans that do not have to cover a full range of health benefits.

These plans are opposed by consumer and patient advocates and others, who have warned that they will drive up costs for sicker consumers who need more comprehens­ive health coverage.

The health care law’s core consumer protection­s, which the president once signaled he supported, have been among the most popular parts of the law and have helped extend coverage to millions of previously uninsured Americans.

The legal challenge led by the state of Texas argues that these consumer protection­s — as well as the law’s multibilli­on- dollar program for expanding the Medicaid safety net to poor Americans — should be scrapped because Congress last year repealed the penalty on Americans who don’t have health coverage.

That penalty, Texas and the other conservati­ve states argue, is so central to the law that without it, the rest cannot stand.

Many health care experts disagree with that position. And the Trump administra­tion has not as- serted the Medicaid expansion made possible by the health care law should be rolled back.

But Justice Department lawyers do argue that with no penalty for not having coverage, the federal government cannot make health insurers cover sick consumers or prohibit insurers from charging sick consumers higher premiums, as was routinely done before the health care law was implemente­d.

“The individual mandate is not severable from the (Affordable Care Act’s) guaranteed-issue and community- rating requiremen­ts,” the department noted in its legal filing.

The Trump administra­tion’s move drew criticism from defenders of the health care law and some legal scholars, who noted how unusual it is for the Justice Department not to defend federal law.

Equally notable, three career prosecutor­s in the department withdrew from the case just before the administra­tion announced the decision not to defend the health care law.

“Withdrawin­g from a case en masse like this, right before the brief is filed, is unheard of,” said Nicholas Bagley, a former Justice Department lawyer who now teaches at the University of Michigan Law School.

“These attorneys are civil servants. They routinely defend policies they dislike and make arguments they personally disagree with. That’s the nature of the job. Their withdrawal signals that they believed the arguments in the brief went far beyond the pale — that they were so frivolous they could not endorse them and remain faithful to their profession­al duties.”

 ?? ALEX BRANDON/AP ??
ALEX BRANDON/AP

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