Fresh legal attack on health law comes with political risks

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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.

Mr. MacArthur said it would be hard for Congress to revisit the brutal health care fight, although it's unclear if the lawsuit will get "any legs under it".

She cited a report from health care think tank Kaiser Family Foundation that estimates more than 52 million Americans have pre-existing health problems that would "likely leave them uninsurable" if it weren't for the Affordable Care Act's regulations. "Congress needs to work in a bipartisan manner to develop a solution that covers pre-existing conditions and makes health care more affordable and accessible for every American".

"This is yet another malicious Republican attack that will undermine the stability of our healthcare system, and could once again mean that you or a loved one are denied healthcare because of a pre-existing condition", said Meredith Kelly, the communications director of the Democratic Congressional Campaign Committee (DCCC). That ruling hinged on the reasoning that, while the government "does not have the power to order people to buy health insurance", as Chief Justice John Roberts wrote for the majority, it "does have the power to impose a tax on those without health insurance".

The news rallied defenders of the law into action and raised questions among legal scholars about the likelihood it would succeed.

"And the Department of Justice is ending the lawlessness that too often took place under the previous administration", Sessions said, according to the prepared remarks.

Weighing in on a Texas challenge to the health law, the Justice Department argued that legally and practically the popular consumer protections can not be separated from the unpopular insurance mandate, which Congress has repealed, effective next year. The DOJ in fact sided in large part with the states, arguing that the law's protections for people with pre-existing conditions should be invalidated.

Becerra estimated that the states that back the health care law could lose half a trillion dollars in health care funding if the suit is successful.

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Democrats, who were already favored going into this November's election both on the generic ballot and on health care in particular, pounced on the news of the lawsuit, predicting "serious blowback in the midterms" for Republicans.

A coalition of 20 USA states sued the federal government in February, claiming the law was no longer constitutional after last year's repeal of the penalty that individuals had to pay for not having insurance. But past year the Republican-controlled Congress eliminated those penalties as part of the $1.5 trillion tax overhaul that Trump signed in December.

While they provide major protections to those with pre-existing conditions, they also have pushed up premiums for those who are young and healthy.

Attempts to repeal it in Congress have failed, but opponents of the law have also filed scores of lawsuits challenging various provisions. Under another provision, the community rating provision, insurers were not allowed to set premiums based on a person's health history. "At the worst it could strip away guaranteed coverage for those with pre-existing conditions".

Until Thursday's filing, the Trump administration had not indicated its position on either this latest lawsuit or the Republican states' effort to block the law while the case moved along.

Donald B. Verrilli Jr., a solicitor general in the Obama administration, said there were obviously reasonable arguments that could be made in defense of the Affordable Care Act in the Texas case, pointing to those in a brief filed Thursday by California and 15 other states. "It's being mugged", King said in a twitter statement on Friday.

Just hours before the Justice Department officially withdrew from the case, three of the staff attorneys who had been working on it withdrew. But the Department of Health and Human Services could, in theory, create exceptions to those rules or rewrite them in way that could upend coverage for some consumers midyear, Levitt said.

But Justice Department lawyers do argue that with no penalty for not having coverage, the federal government can not 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. Ultimately, the issue could be decided by the Supreme Court. In their suit, lodged in February in the U.S. District Court for the Northern District of Texas, they argue that the entire law is now invalid.

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