- The Washington Times - Wednesday, June 13, 2018

Patient advocates will tell a federal judge on Thursday to reject the Trump administration’s position that much of Obamacare is now illegal, warning that if more people are kicked out of their health plans, “they die.”

The administration told a judge in Texas last week that it won’t defend Obamacare against a lawsuit filed by Republican-led states seeking to undo the law’s requirement that insurers cover people with pre-existing conditions who try to buy plans in the exchanges.

But the patient groups, who will file briefs in the case Thursday, say Americans with cancer, diabetes and heart disease would suffer immediately if the courts strike down those parts of the Affordable Care Act.

Even people who’ve never had major health issues should worry about returning to pre-Obamacare rules, the groups argue, pointing to insurers who used to rummage through medical histories for any excuse to avoid payouts.

“Before the Affordable Care Act, even healthy people who could get a health insurance policy were often dropped or faced rejection of their medical bills,” said Kathleen Skambis, and American Lung Association board member and lung cancer survivor.

Mary Rouvelas, senior counsel at the American Cancer Society Cancer Action Network, said the evidence is clear: “If people don’t have real health insurance — comprehensive health insurance — they die.”

The Texas case has quickly turned into a major showdown over Obamacare’s future. The GOP-led states argue that after Congress nixed the individual mandate requiring all Americans to have insurance as part of last year’s tax-cut law, the legal justification for other parts of the 2010 law also disappears.

One of those other parts is Obamacare’s protections for sicker Americans. As written, the law prodded healthier people into the marketplace through the individual mandate, then used their premiums to help cover the costs of the sicker customers who could no longer be denied coverage.

The administration says it supports coverage for pre-existing conditions as a matter of policy, but last week informed U.S. District Court Judge Reed O’Connor that it couldn’t disagree with the GOP-led states’ legal reasoning.

Republican policymakers are being pushed to take sides in the emerging case.

Senate Health Committee Chairman Lamar Alexander bluntly opposed the administration’s position, saying he “didn’t hear a single senator say” they wanted to scrap the protections when they zeroed out penalties tied to Obamacare’s “individual mandate” in last year’s tax overhaul.

“The Justice Department argument in the Texas case is as far-fetched as any I’ve ever heard,” the Tennessee Republican said.

Senate Majority Leader Mitch McConnell said his troops still favor protecting people with preexisting conditions and shifted blame onto Democrats, who walked away from an Obamacare stabilization package last year. He noted the administration is working on its own plans to expand cheaper options.

Health Secretary Alex Azar sidestepped the debate Tuesday, telling Congress the Justice Department took a “legal position” as opposed to one steeped in policy.

A Kaiser Family Foundation taken last June said seven in 10 Americans think the federal government should continue to bar health insurers from charging people with pre-existing conditions more for their coverage.

Senior House Democrats asked the Justice Department on Wednesday to justify its decision not to defend the 2010 law.

Refusing to defend a law is not unprecedented — the Obama administration made the same move with respect to the Defense of Marriage Act, declining to defend it.

Still, Democrats argue the department’s decision was a political move.

“In failing to defend these provisions, the Trump Administration is trying — yet again — to sabotage the ACA at the expense of consumers across the nation,” the Democrats wrote to Attorney General Jeff Sessions. “Your decision could subject millions of Americans with pre-existing conditions to the same discrimination they faced before the passage of the ACA.”

• Tom Howell Jr. can be reached at thowell@washingtontimes.com.

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