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Trump Administration Won't Defend ACA


The U.S. Justice Department says that key parts of the Affordable Care Act are unconstitutional. In a brief filed in federal court this week, the department said that parts of the health care law should not stand. To learn more about the lawsuit, we turn now to Julie Rovner, chief Washington correspondent for Kaiser Health News. Julie, thanks so much for being with us.


SIMON: And let's start with the question of the individual mandate. Hasn't the Supreme Court already found the individual mandate as constitutional?

ROVNER: Yes, the individual mandate itself is constitutional because it's a tax. What's at issue here is the fact that Congress is getting rid of the penalty for the individual mandate, reducing it to zero as of next January 1 - January 1, 2019. So what these Republican attorneys general are arguing is that without the penalty everything else in the law is unconstitutional.

SIMON: Now, let me ask you about another central part of the ACA. And that's the provision they have about preexisting conditions. It requires insurance companies to cover people with preexisting conditions - charge them the same rates as everybody else? Does this lawsuit put that feature in jeopardy?

ROVNER: Yes, it does. Now, of course, as I mentioned, the attorneys general say that the entire rest of the law is unconstitutional without that penalty for not having insurance. What the Justice Department is arguing is that most of the rest of the law is still OK. But without that part, those preexisting condition provisions - requiring that people with preexisting conditions be able to get coverage, requiring that they pay the same - those two would be invalidated by the elimination of the penalty for not having coverage.

SIMON: What other parts of the ACA does the Department of Justice single out in the lawsuit?

ROVNER: Those are the main parts. So they're saying that when the mandate penalty goes away next January, the protections for preexisting conditions should go away as well. That's not exactly what the attorneys general were arguing, but that's what the Justice Department position is.

SIMON: How might this change how individual people are covered and treated in this country?

ROVNER: Well, immediately, of course, it wouldn't. The Justice Department isn't asking for anything immediately. Obviously, this is a lawsuit, and it could take months or even years to work its way through the courts. But it does certainly raise the prospect of a court decision that would say there could be no more protections for people with preexisting conditions. That's one of the most popular parts of the health law.

SIMON: We've been getting reports from all over the country about how health care premiums are going up. Why is that happening? Do you expect it to keep happening?

ROVNER: Well, one of the reasons it's happening - say the insurers, who are filing their rates now for next year - is because they took away this penalty for people who don't have insurance. The insurers say that healthy people will probably opt out of having insurance. That will leave sicker people buying insurance. So they have to raise premiums. The Trump administration is also trying to make it easier for healthier people to get less comprehensive health insurance, which would also take more healthy people out of the pool where most people buy their individual insurance. And for those reasons, premiums are going up more next year than they would have otherwise.

SIMON: And you expect this to continue?

ROVNER: Yes. We've only seen, you know, a handful of states so far. But in every state, insurers have said that's the reason they're raising their premiums.

SIMON: Julie Rovner, chief Washington, DC, correspondent for Kaiser Health News. Thanks so much for being with us.

ROVNER: You're so welcome. Transcript provided by NPR, Copyright NPR.