Democrats begin their defense of Obamacare as the courts weigh in | News Coverage from USA

Democrats begin their defense of Obamacare as the courts weigh in

WASHINGTON – House Democrats on Wednesday will ramp up their defense of Obamacare, one of their first actions following midterm elections in which they won the House after pounding away on the issue of health care.

Democrats will vote to authorize House attorneys to oppose a challenge to the Affordable Care Act by Republican attorneys general. A Texas judge recently agreed with the attorneys general that the landmark health care law is unconstitutional.

Democrats have also made lowering prescription drug prices a top priority, one of the few issues on which they could find common ground with Republicans who control the Senate and White House. But on another health care issue, Medicare for all, they face debate even within their own ranks on how far to go.

While prospects for legislative action are uncertain in a divided government, there is plenty going on in the courts this month that could affect people’s insurance coverage.

For example, the Trump administration’s attempt to make it easier for employers to exclude contraceptive coverage from insurance plans begins Jan. 14 unless a judge intervenes. Courts are also considering challenges to other ACA changes that the administration argues will give consumers more choices but that critics say will make insurance more expensive for those who need care.

Here’s a look at where things stand:

Obamacare challenge

Judge Reed O’Connor, a U.S. District Court judge in the Northern District of Texas, ruled in December that the entire ACA is invalid. He said the Republican tax cut bill knocked the constitutional foundation out from under Obamacare by eliminating the penalty for not having coverage. The law, which remains intact during the appeals process, created not just the controversial Obamacare insurance plans but also many popular provisions now in jeopardy such as protections for people with pre-existing conditions, an expanded drug benefit for seniors, and allowing young adults to stay on their parents’ insurance plans.

House Democrats are joining Democratic attorneys general in defending the law. But University of Michigan law professors Nicholas Bagley and Richard Primus argue the best way for Democrats to stop the latest ACA challenge is through legislation. For example, Congress could make explicit what was implicit in the removal of the penalty for being uninsured – that the ACA does not hinge on a mandate to buy insurance.

Trumpcare challenges

After congressional Republicans failed to repeal the ACA, the Trump administration has tried to write new rules on its own. One would dramatically expand the ability of employers to exclude contraceptive coverage in insurance plans for religious reasons. The attorneys general from California, Pennsylvania and some other states are trying to keep the rule from going into effect Jan. 14.

Democratic attorneys general, consumer activists and others are also suing to stop the administration from expanding access to association health plans and to short-term coverage. The administration says consumers need alternatives to Obamacare plans, which can be expensive, especially for those who don’t qualify for subsidies. But opponents say that because the alternatives have fewer consumer protections and benefits, they will siphon healthy customers out of the Obamacare market – increasing the premiums for everyone left. In a letter sent to the White House Tuesday, congressional Democrats asked for more information on the proposed short-term plans – which they argue would not be legal.

Prescription drug prices

Following through on Trump’s promise to reduce the cost of prescription drugs, the administration has rolled out various proposals that analyst Rachel Sachs of Washington University in St. Louis said range from radical to more modest ideas. Most, however, remain in draft form, Sachs wrote in a recent piece for the policy journal Health Affairs.

House Democrats have named tackling drug prices as one of their top legislative priorities. Proposals include longstanding Democratic plans to allow Medicare to negotiate for lower drug prices and newer ones that would require the government to make generic medicines. Vermont Sen. Bernie Sanders even has a proposal that has the same approach as a Trump administration plan – lowering prices by tying them to what other countries pay.

Medicare for all

A single-payer system such as Medicare for all is a popular rallying cry among progressives. Trump tried to defeat Democrats during the midterm elections by claiming it was “just the beginning” of the other party’s “socialist agenda.”

House Speaker Nancy Pelosi, D-Calif., faces a balancing act in letting the more liberal members of her caucus explore the idea without it become a political albatross for the 2020 elections. She gave the green light for hearings to be held. But she’s also cautioned that the proposal needs to be evaluated in terms of costs and benefits.

“Medicare for all sounds as a good idea, but Medicare is not as good of benefits as the Affordable Care Act is, if you work, if you’re younger,” Pelosi said in an MSNBC town hall interview last week. “The Medicare for all, you have to review, what are the benefits?”

 

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