This looks big to me, a move by the Trump administration to stop defending key parts of the Affordable Care Act, including bans on denial of coverage or higher rates for people with pre-existing medical conditions.

So far, news coverage has been scant. The Wall  Street Journal reported that, in response to a suit by Republican attorneys general, including Leslie Rutledge of Arkansas, the Justice Department has said it won’t defend provision and is asking the court to halt them.


Andy Slavitt, who ran Medicare and Medicaid for President Obama, calls it the biggest health news of the year. You can read his Twitter thread on the topic here.

You’d think this would have political consequences given the untold number of (sick) people it would harm. But there’s a cynical element. From Slavitt:


This collusion between the conservative plaintiffs and the “defense” would make pre-ex protections and age rating protections unconstitutional.

In an active of savage cynicism, the Trump Administration doesn’t want this to go into effect until after the election.

Some legal experts think the Justice Department arguments and the Republican lawsuit are weak legally. Time will tell. Meanwhile, what if they succeed? Some more of Slavitt’s commentary:

I am going got try to cover what happened and what is likely to happen next.

A gift for insurance companies and the infliction of harm on the lives of 130 million Americans w pre ex conditions or older Americans.

So what happened…

Two really destructive instincts have combined: a desire to turn back the ACA and hurt the millions who benefit from it (not through the exchanges but through the protections) AND an unprecedented move by the Justice Dept. not to defend the rule of law in a frivolous case.

FOR AMERICANS WITH PRE EXISTING CONDITIONS: This is game on that the Administration is against you. Same if you ever may get sick.

(Excuse all CAPS for looking like I’m yelling. But I’m literally in a restaurant in DC and feel like I should probably be yelling

Yelling seems in order. But given that the populace includes a contingent around 40 percent that seems deaf and blind to the actions of the administration, it might produce only a sore throat.


UPDATE: Health Care for America Now issued a statement on the news:

In response to the Department of Justice’s refusal to defend the Affordable Care Act against a legal challenge, Health Care for America Now Co-Directors Ethan Rome and Margarida Jorge released the following statement:

“The Trump Administration is once again using every possible weapon in its arsenal to sabotage America’s health care and undermine the Affordable Care Act – without a single thought to the Americans who will be denied coverage for preexisting conditions, see their premiums and out-of-pocket costs skyrocket, be charged more for being women, and be priced out of preventive care. Despite repeated failed attempts to repeal the law in Congress and overwhelming bipartisan opposition to repeal in communities across the country, the administration continues its war on America’s health care. Their war has got to stop, and the DOJ should do its job – defend the law of the land.

“We cannot return to the days when insurance companies were in charge of our health care, without any rules to stop discrimination or hold them accountable for providing decent coverage. We need to expand access to affordable care, not relitigate a question the Supreme Court already answered years ago in a desperate attempt to undermine a law that helps millions of Americans get the care they need and provides protections to the more than 129 million Americans with preexisting conditions.”