Trump gets his day in court to destroy health care


Tomorrow, oral arguments in the case Texas v. United States – a lawsuit brought by President Trump and 19 Republican governors or attorneys general to declare the Affordable Care Act unconstitutional – start in the 5th Circuit Court of Appeals in New Orleans.

If the Trump administration’s lawsuit is successful, our health care system will be thrown into chaos: millions of Americans would lose their health care, 130 million Americans with pre-existing conditions would lose their protections and millions more would be subject to higher costs and worse coverage. 

For years, President Trump and his Republican allies have tried to repeal the health care law, and after failing repeatedly to do so in Congress, they have turned to the courts to mount their latest assault. 

Tomorrow we will hear directly from Trump’s lawyers who will make their case in court for destroying America’s health care. In contrast, 21 Democratic attorneys general led by California AG Xavier Becerra and patient advocacy organizations around the country have mounted a legal defense against the Trump lawsuit, fighting to protect the health care of millions of Americans. 

Timeline of the Texas lawsuit – how we got here: 

February 2018: Texas and a coalition of Republican states sued the Department of Health and Human Services (HHS), seeking to take away health insurance from millions of Americans. The Republican-led states argued that because Congress had eliminated the individual mandate the entire ACA should be unconstitutional. 

June 2018: The Trump administration took the unprecedented step of refusing to defend the Affordable Care Act against the Republican lawsuit, effectively joining the lawsuit and specifically arguing in court that the individual mandate, as well as protection for 130 million Americans with pre-existing conditions, should be eliminated.  

December 2018: A cherry-picked federal judge, Reed O’Connor, ruled in favor of the 19 conservative states to overturn the Affordable Care Act, jeopardizing coverage for 19 million people and ripping away the ACA’s vital consumer protections such as protections for people with pre-existing conditions.

March 2019: The Trump administration doubled down on its support for the lawsuit against the health care law, sending a letter to the court stating that, in addition to supporting the destruction of protection for pre-existing conditions and the individual mandate, they would be refusing to defend the ACA in its entirety. 

July 2019: Trump’s lawyers will head to New Orleans on July 9 to make the case to destroy the health care law before the 5th Circuit Court of Appeals for oral arguments in the case. 

Bottom line: The health care of millions of Americans is at stake in this lawsuit. Shining a spotlight on this case is critical to ensuring that Americans understand the consequences of what happens to their health care if the Affordable Care Act is overturned. If successful in their case, millions of Americans will lose coverage, protections for pre-existing conditions will end, Medicaid will be gutted and costs will go up across the board. 

This lawsuit defines the real Trump health care plan: to destroy the landmark law as a means to score a political victory while callously throwing millions off their insurance in the process. This is a legacy-defining issue for Trump, who refuses to let go of his long-standing desire to dismantle America’s health care system.

Leading legal scholars, including conservatives, have said the Trump lawsuit makes no legal sense: for example, conservative legal scholar Jonathan Adler and health law professor Abbe Gluck, argued that the decision “makes a mockery of the rule of law and basic principles of democracy.”  Other experts have described the decision as “absolutely insane” and a “big Invasion of legislative power.” 

Dozens of doctors and leading patient advocacy groups have made clear the results of this lawsuit would be catastrophic for Americans’ health care. For instance, the American Medical Association and four other physician groups argued that invalidating the ACA would have “a devastating impact on doctors, patients, and the American health care system as a whole.”

Here’s how the Trump lawsuit to dismantle the ACA would devastate Iowans:

  • 187,000 Iowans would lose their coverage, causing a 126 percent increase in the uninsured rate.
  • Medicaid expansion would be repealed, meaning the 155,400 Iowans who are covered through Medicaid expansion could lose coverage.
  • 51,596 Iowa seniors will pay more for prescription drugs because the Medicare “donut hole” will be reopened.
  • Protections for women, who insurance companies previously charged 50 percent more than men, would be gone.
  • Financial assistance that helps 39,039 Iowans purchase health care in the marketplace would end.
  • Key support for rural hospitals would disappear, leaving Iowa hospitals on the hook for $684 million more in uncompensated care costs.
  • 1,530,502 Iowans could once again have to pay for preventive care, like mammograms and flu shots.
  • Insurers will no longer have to cover a set of essential health benefits, including hospitalization, prescription drugs, or mental health services.