The mandate has always been a sticking point for conservatives, who argue that the government should not be telling individuals what coverage they must have. Without the mandate, it said the law's consumer protections for people with preexisting conditions can not stand.
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the popular consumer protections can not be separated from the unpopular insurance mandate, which Congress has repealed, effective next year. HHS and Treasury administer the health law's coverage and subsidies.
The popularity of those provisions made repeal politically unsafe, so Republicans chose to leave the popular parts in place and try to repeal only the unpopular parts.
If they succeed, it will be in no small part because Republicans made voters so disgusted with the existing health care system and afraid for their own health security that they're willing to support radical change. Other parts established rules for major medical plan benefits summaries, provided funding for geriatric care provider education programs, and moved to lower out-of-pocket costs for people who have Medicare Part D prescription drug plan coverage and high prescription bills. The individual mandate required most Americans to maintain minimum insurance or to pay a tax penalty. Health officials halved the sign-up period to buy ACA health plans, cutting from $100 million to $10 million an advertising budget to help encourage consumers to sign up, and slashed funds for grass-roots organizations that helped people enroll.
In 2012, the U.S.
The Trump administration argues that because the new tax law eliminates the penalty for not buying insurance, the Supreme Court's previous ruling permitting the mandate as a tax no longer applies. However, following the passage of the Tax Cut and Jobs Act of 2017 (TCJA) [text, PDF], the tax penalty would not be imposed as of 2019.
But others say the legal brief may have minimal impact next year on premiums.
Led by Texas Attorney General Ken Paxton and Wisconsin Attorney General Brad Schimel, the lawsuit said that without the individual mandate, Obamacare in its entirety was unlawful.
Sessions said because there is no longer a tax that brings in federal revenue, he would not uphold the individual mandate.
Several Republicans expressed bewilderment at the notion that this protection could be declared unconstitutional or overturned. A Justice Department spokeswoman said the lawyers' withdrawal had been a department decision, declining to specify whether the lawyers had personally objected to continuing on the case.
The case is Texas v. U.S., 4:18-cv-001 67, U.S. District Court, Northern District of Texas (Fort Worth).
About 1.5 million Californians buy coverage through the states ACA exchange, Covered California, and almost 4 million have joined Medicaid as a result of the programs expansion under the law. By withdrawing from defending the law in court, the Trump administration is saying it no longer supports those consumer protections, which are popular with voters. O'Connor has told those states they can submit pleadings to the court along with the other parties. Health insurers are now deciding whether to sell coverage in the individual market in 2019 - and what they're going to charge. But it's crucial to remember that this was exactly the reaction of the same set of people in 2010, when the original argument was made against the individual mandate by libertarian law professor Randy Burnett.
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.
"On behalf of the millions of Americans we represent, we urge the administration to reconsider its position", the statement concluded. However, we believe that a declaratory judgment would have the same destabilizing effect as a preliminary injunction, and therefore should not be granted.
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". "Instead, we should focus on advancing proven solutions that ensure affordability for all consumers".
It will likely take years for the case to wend its way through the courts, meaning the uncertainty could linger over insurers for some time, according to Spencer Perlman, an analyst at Veda Partners. Law&Crime will be monitoring and will provide more information should it become available.