{"id":138418,"date":"2019-03-26T00:05:56","date_gmt":"2019-03-26T06:05:56","guid":{"rendered":"http:\/\/hill-kleerup.org\/blog\/?p=138418"},"modified":"2019-03-26T00:05:56","modified_gmt":"2019-03-26T06:05:56","slug":"trump-finds-a-new-avenue-of-attack-on-the-aca","status":"publish","type":"post","link":"https:\/\/hill-kleerup.org\/blog\/2019\/03\/26\/trump-finds-a-new-avenue-of-attack-on-the-aca.html","title":{"rendered":"Trump finds a new avenue of attack on the ACA"},"content":{"rendered":"<p>Donald Trump has made &#8220;Repeal (and, I guess, Replace)&#8221; of the Affordable Care Act one of his priorities since Day 1 of his election. He&#8217;s tried (and failed) to wrangle Congress into doing it for him. He&#8217;s chipped away steadily at it through executive action, undoing implementation orders from the Obama era. He&#8217;s now escalated his efforts to do so on a judicial basis<\/p>\n<p>Trump&#8217;s Justice Department has decided to file a brief in the appeal of a Texas judge&#8217;s ruling that the entire ACA (&#8220;Obamacare&#8221;) is unconstitutional because the GOP Congress got rid of the individual mandate. The brief is in support of that ruling, thus expanding\u00a0 the DoJ&#8217;s previous positions in the case that only portions of the law should be tossed out. Now, it&#8217;s\u00a0<em>Get rid of everything\u00a0<\/em>as the official Justice Dept. position.<\/p>\n<p><a href=\"https:\/\/hill-kleerup.org\/blog\/wp\/wp-content\/uploads\/2017\/09\/Donald-Trump-in-front-of-a-flag.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-134787\" title=\"Donald Trump in front of a flag\" src=\"https:\/\/hill-kleerup.org\/blog\/wp\/wp-content\/uploads\/2017\/09\/Donald-Trump-in-front-of-a-flag.jpg\" alt=\"\" width=\"506\" height=\"367\" srcset=\"https:\/\/hill-kleerup.org\/blog\/wp\/wp-content\/uploads\/2017\/09\/Donald-Trump-in-front-of-a-flag.jpg 506w, https:\/\/hill-kleerup.org\/blog\/wp\/wp-content\/uploads\/2017\/09\/Donald-Trump-in-front-of-a-flag-150x109.jpg 150w, https:\/\/hill-kleerup.org\/blog\/wp\/wp-content\/uploads\/2017\/09\/Donald-Trump-in-front-of-a-flag-300x218.jpg 300w\" sizes=\"auto, (max-width: 506px) 85vw, 506px\" \/><\/a><\/p>\n<p>Were the 5th Circuit to uphold that position, both the short-term and long-term effects would be catastrophic. On the short-term side it would throw private insurance and public assistance into turmoil. On the long-term side, it would mean a return to the pre-ACA days:<\/p>\n<ul>\n<li>Returning to Pre-Existing Condition restrictions that prevented millions of Americans from getting health insurance (at all, or at affordable levels), and locked people into jobs for fear that they wouldn&#8217;t requalify for health insurance if there was too long a gap between employment positions<\/li>\n<li>Returning to having lifetime and annual coverage limits<\/li>\n<li>Returning to letting insurance companies charge more for women&#8217;s health coverage<\/li>\n<li>Dumping 15 million people off Medicaid<\/li>\n<li>Eliminating no-charge preventative services for older Americans on Medicare<\/li>\n<li>Removing required minimal coverage standards for health insurance policies (ambulatory care, emergency care,\u00a0hospitalization, maternity and newborn care, mental health and substance use\u00a0care, prescription drugs, rehabilitative and habilitative services, laboratory\u00a0services, preventive care, chronic disease management, and pediatric dental and\u00a0vision care)<\/li>\n<li>Removing state exchanges that provided structured comparisons of medical insurance plans<\/li>\n<li>Removing\u00a0medical loss ratio standards that required insurance companies to expend money primarily on coverage, not on executive salaries.<\/li>\n<li>Kicking off extended dependent coverage to age 26<\/li>\n<li><a href=\"http:\/\/files.kff.org\/attachment\/Summary-of-the-Affordable-Care-Act\">Etc.<\/a><\/li>\n<\/ul>\n<p>The only &#8220;positive&#8221; aspect of this is that, regardless of how the 5th Circuit (and then the Supreme Court, one can assume) rules on this, Trump has prominently handed a <em>huge<\/em> issue to the Democrats in 2020. Protecting health care was a major component of the message in 2018 that won the Dems the House (and arguably staved off greater losses in the Senate). It polls as the most important issue for Democratic voters, while repealing the ACA is much further down the list for Republicans.<\/p>\n<p>Trump has long touted &#8220;Repeal and Replace&#8221; as his goal, even though the replacements proposed have been weak beer in terms of actually helping those whom the ACA provided care for. With this move, Trump&#8217;s administration is seeking solely to Repeal; any &#8220;Replace&#8221; will be a long time coming, as we devolve to the far-more-Darwinian status quo of a decade ago, where health care was for those who could afford what insurance companies chose to charge.<\/p>\n<p>But, then, despite claims to the contrary, that&#8217;s clearly been Trump&#8217;s desire all along.<\/p>\n<p><em>Do You Want To Know More?<\/em><\/p>\n<ul>\n<li><a href=\"https:\/\/theincidentaleconomist.com\/wordpress\/wp-content\/uploads\/2019\/03\/letter-from-DOJ.pdf\">Microsoft Word &#8211; texas v united states &#8212; letter<\/a><\/li>\n<li><a href=\"https:\/\/www.washingtonpost.com\/nation\/2019\/03\/26\/trump-administration-asks-court-totally-repeal-obamas-affordable-care-act\/?utm_term=.d4b2ec829ffb\">Trump administration backs full repeal of Affordable Care Act in legal reversal &#8211; The Washington Post<\/a><\/li>\n<li><a href=\"https:\/\/www.vox.com\/policy-and-politics\/2019\/3\/25\/18281788\/doj-obamacare-unconstitutional-trump\">Trump\u2019s DOJ says Obamacare is unconstitutional in lawsuit &#8211; Vox<\/a><\/li>\n<li><a href=\"http:\/\/files.kff.org\/attachment\/Summary-of-the-Affordable-Care-Act\">Summary of the Affordable Care Act<\/a><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>He couldn&#8217;t do it through Congress, and hasn&#8217;t quite managed it by Executive Order, so &#8230;<\/p>\n","protected":false},"author":2,"featured_media":134787,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_seopress_robots_primary_cat":"","_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"","_seopress_analysis_target_kw":"","_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[528,1142,134,1071],"tags":[1171,1077],"class_list":["post-138418","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-economic-justice","category-elections-2020","category-health-care","category-trump","tag-aca","tag-trump"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/hill-kleerup.org\/blog\/wp\/wp-content\/uploads\/2017\/09\/Donald-Trump-in-front-of-a-flag.jpg","jetpack_sharing_enabled":true,"jetpack-related-posts":[{"id":132133,"url":"https:\/\/hill-kleerup.org\/blog\/2016\/12\/01\/to-provide-fewer-human-services-for-health.html","url_meta":{"origin":138418,"position":0},"title":"To provide fewer Human Services for Health","author":"***Dave","date":"Thu 1-Dec-16 7:02am","format":false,"excerpt":"Getting rid of the Affordable Care Act has been the top priority for the GOP since it was passed (heck, probably before that). With control of both chambers of Congress and the White House, something along those lines is likely.Which is a bit of a challenge for the GOP, because\u2026","rel":"","context":"In &quot;~PlusPosts&quot;","block_context":{"text":"~PlusPosts","link":"https:\/\/hill-kleerup.org\/blog\/category\/blogging\/plusposts"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":133674,"url":"https:\/\/hill-kleerup.org\/blog\/2017\/06\/14\/trump-now-thinks-the-house-aca-repeal-bill-was-too-harsh.html","url_meta":{"origin":138418,"position":1},"title":"Trump now thinks the House ACA repeal bill was too harsh","author":"***Dave","date":"Wed 14-Jun-17 10:02am","format":false,"excerpt":"Back when the House GOP passed the AHCA, Trump triumphantly tweeted:'It was a GREAT day for the United States of America! This is a great plan that is a repeal & replace of ObamaCare. Make no mistake about it.' [1]Now, as he tries to badger the Senate into getting something\u2026","rel":"","context":"In &quot;~PlusPosts&quot;","block_context":{"text":"~PlusPosts","link":"https:\/\/hill-kleerup.org\/blog\/category\/blogging\/plusposts"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":133762,"url":"https:\/\/hill-kleerup.org\/blog\/2017\/06\/30\/repeal-now-replace-later-pinky-swear.html","url_meta":{"origin":138418,"position":2},"title":"Repeal Now, Replace Later (Pinky-Swear!)","author":"***Dave","date":"Fri 30-Jun-17 11:36am","format":false,"excerpt":"The Senate (okay, the GOP Barely-a-Majority in the Senate) has been unable as of yet to get an ACA \"Repeal and Replace\" bill passed. The reasons are many, but it comes down to too many conservative Senators don't think the AHCA goes far enough in throwing people off Medicaid and\u2026","rel":"","context":"In &quot;~PlusPosts&quot;","block_context":{"text":"~PlusPosts","link":"https:\/\/hill-kleerup.org\/blog\/category\/blogging\/plusposts"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":134894,"url":"https:\/\/hill-kleerup.org\/blog\/2017\/10\/02\/dont-think-theyre-trying-sabotage-aca-well-course.html","url_meta":{"origin":138418,"position":3},"title":"You don&#8217;t think they&#8217;re trying to sabotage the ACA, do you? Well, of course!","author":"***Dave","date":"Mon 2-Oct-17 12:25pm","format":false,"excerpt":"Reduced enrollment period, weekend outage windows, reduced assistance budget, reduced advertisement \/ reminders about enrollment ... it's almost as if they want ACA exchange usage to go down, especially among younger, healthier people, further driving up the price of insurance ... which they can then blame on the ACA. If\u2026","rel":"","context":"In &quot;~PlusPosts&quot;","block_context":{"text":"~PlusPosts","link":"https:\/\/hill-kleerup.org\/blog\/category\/blogging\/plusposts"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/hill-kleerup.org\/blog\/wp\/wp-content\/uploads\/2017\/10\/ACA-healthcare-dot-gov.png?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":136349,"url":"https:\/\/hill-kleerup.org\/blog\/2018\/05\/09\/balancing-the-budget-on-the-backs-of-poor-children.html","url_meta":{"origin":138418,"position":4},"title":"Balancing the budget on the backs of poor children","author":"***Dave","date":"Wed 9-May-18 10:59am","format":false,"excerpt":"CHIP (the Children's Health Insurance Program) is highly popular (and highly effective), but the GOP in Congress let its funding lapse (they were \"too busy\" trying to repeal the ACA), and now Trump is proposing that Congress try to claw back some of the wildly imbalanced budget he's responsible for\u2026","rel":"","context":"In &quot;~PlusPosts&quot;","block_context":{"text":"~PlusPosts","link":"https:\/\/hill-kleerup.org\/blog\/category\/blogging\/plusposts"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/hill-kleerup.org\/blog\/wp\/wp-content\/uploads\/2018\/05\/trump-talks-to-kids.jpg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":132491,"url":"https:\/\/hill-kleerup.org\/blog\/2017\/01\/03\/tweetizen-trump-2017-01-03-and-a-rambling-new-year.html","url_meta":{"origin":138418,"position":5},"title":"Tweetizen Trump &#8211; 2017-01-03 &quot;And a Rambling New Year&quot;","author":"***Dave","date":"Tue 3-Jan-17 7:48am","format":false,"excerpt":"I recall reading one of your spokesfolk positing your Twitter addiction as a good thing, Donald, as it let you discuss matters with the American public without the media filtering you.Which is all well and good, except that (a) the media report your every word anyway, and (b) a \"discussion\"\u2026","rel":"","context":"In &quot;~PlusPosts&quot;","block_context":{"text":"~PlusPosts","link":"https:\/\/hill-kleerup.org\/blog\/category\/blogging\/plusposts"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]}],"_links":{"self":[{"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/posts\/138418","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/comments?post=138418"}],"version-history":[{"count":1,"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/posts\/138418\/revisions"}],"predecessor-version":[{"id":138420,"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/posts\/138418\/revisions\/138420"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/media\/134787"}],"wp:attachment":[{"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/media?parent=138418"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/categories?post=138418"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/tags?post=138418"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}