Trump’s Surprising New Assault on Obamacare
Health Care

Trump’s Surprising New Assault on Obamacare

Leah Mills/Reuters

A new fight over the future of the Affordable Care Act has erupted in the nation’s capital — and is likely to ensure that health care remains in the spotlight through the 2020 elections.

In a dramatic shift, the Trump administration has asked a federal appeals court to invalidate the Affordable Care Act in its entirety, according to a legal filing made Monday night.

The administration had previously said that the ACA’s protections for people with pre-existing conditions should be struck down, but that the rest of the law could remain in place. But in a Justice Department letter sent Monday night to the United States Court of Appeals for the Fifth Circuit, the Justice Department said the court should affirm an earlier ruling by a federal judge declaring the entire law invalid.

In December, Judge Reed O'Connor had ruled that the ACA’s individual mandate had become unconstitutional after Republicans eliminated its penalties as part of their 2017 tax overhaul. O’Connor further said that the change rendered the entire ACA invalid.

What’s at stake: If O’Connor’s ruling stands, more than 20 million people who currently receive health insurance through the federal exchanges and Medicaid expansion stand to lose coverage. The law touches on many parts of the health care system that would be affected as well, such as FDA approval of biologic medicines and rules on nutritional labeling.

Nicholas Bagley, a professor at the University of Michigan Law School who served in the Justice Department during the Obama administration, says that “the sheer reckless irresponsibility is hard to overstate. The notion that you could gut the entire ACA and not wreak havoc on the lives of millions of people is insane. The Act is now part of the plumbing of the health-care system. Which means the Trump administration has now committed itself to a legal position that would inflict untold damage on the American public.”

A political boomerang? President Trump tweeted Tuesday that “The Republican Party will become ‘The Party of Healthcare!’” But given how the issue helped Democrats in the 2018 election — and how Republicans have struggled to come up with a replacement for Obamacare — this move left many political analysts scratching their heads. Fresh off a huge political victory in the Russia investigation, the White House shifted the conversation back to far less favorable grounds. “Politically, this makes no sense,” Axios’ Sam Baker says. “Chuck Schumer and Nancy Pelosi must be dancing in the streets.”

CNN’s Chris Cillizza says that the decision to go after Obamacare in full ensures that health care will be a deciding factor in the 2020 election, in ways that could hurt Republicans:

“Switching the spotlight of the national debate from Russia to health care so quickly would be risky under any circumstances but is particularly problematic given that a) the past five elections have shown that people care deeply about and vote on the issue of health care and b) getting rid of Obamacare is not a broadly popular view with the American public.”

What’s next: The Justice Department said it would file a brief providing more details on its change in position on the law. The case is likely headed for the Supreme Court, where Chief Justice John Roberts could once again play a deciding role in the fate of the health care law.