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The Journal Gazette

Saturday, June 09, 2018 1:00 am

GOP risks fallout over move on health law

News Services

WASHINGTON – The Trump administration's decision to stop defending in court the Obama health law's popular protections for consumers with pre-existing conditions could prove risky for Republicans in the midterm elections – and nudge premiums even higher.

The Justice Department said in a court filing late Thursday that it will no longer defend key parts of the Affordable Care Act, beginning with the unpopular requirement that people carry health insurance, but also including widely supported provisions that guarantee access for people with medical problems and limit what insurers can charge older, sicker adults.

Friday, the insurance industry warned in stark terms of “harm that would come to millions of Americans” if such protections are struck down, causing premiums “to go even higher for older Americans and sicker patients.”

A Texas challenge to the health law argues that when Congress changed tax law and cut the penalty for not having insurance to zero as of next year, it rendered the individual mandate toothless. And because a scant majority of the Supreme Court had said it was Congress's taxing powers that saved the ACA from being unconstitutional, that protection was no longer there. The entire law must fall, they say.

The Justice Department did not go that far. But it did say Thursday that because the individual mandate is unconstitutional, so is another, more popular part of the law: protections for people with pre-existing conditions. The brief says that part of the law can't be severed from the mandate.

That argument is likely to be lost on consumers, said Robert Blendon, a polling expert at the Harvard T.H. Chan School of Public Health, particularly in the heat of an election that will determine control of Congress.

“The pre-existing condition thing is what the ads will be run on,” said Blendon. “Pre-existing conditions have gotten to be an issue that people walking on the streets understand; ... it's very emotional.”

Some Democratic politicians didn't waste much time.

“Democrats will not allow Republicans to get away with quietly trying to strip away pre-existing conditions protections for millions of Americans through a legal back door,” said Rep. Frank Pallone, D-N.J., a spokesman for his party on health care.

Senate Democratic Leader Chuck Schumer urged President Donald Trump to reverse the decision.

Loosening the health law's rules on pre-existing conditions and on charging more to older adults is a key goal for the Trump administration. Partly that's because those consumer protections also raise premiums across the board, as the cost of covering the sick is spread among all customers, including healthier people who previously benefited from lower rates.

The issues in the court case are unlikely to be resolved quickly, but some experts said the added uncertainty could prompt insurers to seek higher premiums in 2019 for health plans sold to individuals.

“Insurance companies hate uncertainty, and when they face uncertainty, they tend to increase premiums and hedge their bets,” said Larry Levitt of the nonpartisan Kaiser Family Foundation.