Officials: Care Act stays till election
WASHINGTON — President Donald Trump’s administration is planning to keep the Patient Protection and Affordable Care Act in place until after the 2020 presidential election, regardless of how a federal appeals court rules in the coming weeks, according to current and former administration officials.
The administration is asking the appeals court to invalidate the Affordable Care Act, but if the judges throw out all or part of the 2010 health care law, the administration would seek a stay in the ruling, the officials said.
“There will be a stay — it’s not like the decision is going to come down and the world is going to change,” said a senior administration official, who like others spoke on the condition of anonymity to discuss White House strategy.
The White House is caught between its reassurances to voters that a court ruling would not immediately undo the Affordable Care Act, and its decision to side with 18 GOP-led states, including Arkansas, that are arguing that the entire health care law is unconstitutional.
The administration also hopes to slow the case’s progress to the Supreme Court to avoid having its efforts to invalidate the law spotlighted during Trump’s re-election bid, two former administration officials said.
Trump’s Justice Department declined to comment on the case.
The White House has not yet released a viable replacement plan for the Affordable Care Act, also known as Obamacare. Senior administration officials say they have some ideas for replacing parts of the 2010 health care law — “principles” crafted in part by Centers for Medicare and Medicaid administrator Seema Verma.
However, replacing key benefits — such as guaranteed coverage for people with pre-existing conditions — would require the cooperation of Democratic congressional leaders. Those leaders have vowed to defend the law and have no interest in a piecemeal replacement plan that they say could fall short of preserving health coverage for about 20 million Americans.
A trial court judge in Texas ruled last year that the entire law is invalid, and a three-judge panel of the U.S. Court of Appeals for the 5th Circuit is expected to issue an opinion on the case any day.
If the panel upholds the Affordable Care Act, the Trump administration does not have to immediately appeal to the Supreme Court. It could ask the lower court that struck down the law to reconsider the case, or it could request a full 5th Circuit hearing.
The appeals court could also side with the Trump administration and the 18 states and strike down the entire law. Or the judges could take a middle path, targeting the law’s mandate to buy health coverage and its requirements for insurers to cover people with pre-existing conditions without charging them more.
Regardless, legal experts say, the law is likely to end up in front of the Supreme Court for a third time.
Some conservatives are hopeful for that outcome. Tommy Binion, vice president of government relations for the Heritage Foundation, said Republicans’ election messaging “would be buoyed” by Supreme Court deliberations about health care.
“The Democrats are offering Medicare-for-all as their vision for health care,” Binion said. “If it looks like the Supreme Court could strike down the [Affordable Care Act], then Republicans will be offering their vision for health care in this country.”
But many Democrats are also eager for a Supreme Court hearing in the middle of the 2020 campaign. Democrats won the House majority in 2018 after campaigning on maintaining coverage for people with pre-existing conditions, and they are likely to keep it a top election topic if the appeals court rules against the Affordable Care Act.
California Attorney General Xavier Becerra, who is leading the defense of the health care law, could petition the Supreme Court to hear the case next spring, if the appeals court moves to strike the law. If the court agreed, a decision could come in June, five months before the election.
“No one should live in fear of being denied the lifesaving care they are entitled to, including the 133 million Americans with pre-existing conditions,” Becerra said in a statement provided to The Washington Post. “We’re prepared to fight as long and hard as necessary to save the Affordable Care Act.”
Political analysts said the Trump administration wants to pause its repeal efforts until after the election because it does not want to put out a detailed plan for Democrats to pick apart.
“It’s difficult to come up with a solution everyone agrees with and is free market enough,” said Chris Meekins, an analyst with financial services firm Raymond James and a former Health and Human Services official in the Trump administration. “You know whatever you put forward is going to get slashed, so why put a plan that people can shoot arrows at out there?”