DOJ Says ACA Invalid; Pre-Existing Condition Protections; Medicaid Work Requirements
DOJ Sides With Court Ruling ACA Invalid
In a move that echoed the Department of Justice’s (DOJ’s) previous stance on the Affordable Care Act (ACA), the Trump administration’s DOJ announced it was siding with a lower court’s ruling (https://thehill.com/homenews/administration/435759-justice-department-sides-with-court-ruling-obamacare-invalid) that stated ACA was invalid and unconstitutional. Siding with conservative state attorneys general who sued and won a lower federal court judgment on the constitutionality of law (https://voice.ons.org/advocacy/government-shutdown-aca-ruled-invalid-medicare-for-all-push), DOJ issued a terse, two-sentence letter supporting the judge’s decision to strike the law down.
Previously, DOJ had argued that ACA’s protections for pre-existing conditions should be struck down (https://www.theatlantic.com/politics/archive/2018/06/aca-preexisting-conditions-doj/562442/https:/thehill.com/homenews/administration/435759-justice-department-sides-with-court-ruling-obamacare-invalid). DOJ announcement was driven by the White House and given against the wishes of Department of Health and Human Services Secretary Alex Azar and U.S. Attorney General William Barr. Other conservative editorial writers, including those from the Wall Street Journal (https://www.wsj.com/articles/a-losing-health-care-strategy-11553726059), found fault with the decision. ACA’s future is still undetermined and will likely find its way to the Supreme Court, which has previously upheld the law twice in 2012 and 2015.
Democrats, GOP Propose Legislation to Strengthen Pre-Existing Condition Protections
In a strange configuration of dueling press events and policy initiatives, congressional Democrats released their version (https://energycommerce.house.gov/newsroom/press-releases/house-democrats-unveil-legislation-to-strengthen-protections-for-pre) of an enhanced Affordable Care Act at the same time that Senator Rick Scott (R-FL) introduced a budgetary measure to protect patients with pre-existing conditions (https://thehill.com/homenews/senate/436258-rick-scott-to-introduce-amendment-protecting-pre-existing-conditions-amid-aca). Both announcements came in the wake of the Department of Justice’s decision to support a lower court’s decision to invalidate the healthcare law (https://voice.ons.org/advocacy/government-shutdown-aca-ruled-invalid-medicare-for-all-push).
The Democrats’ new bill expands coverage and allows families with greater household income to apply for benefits as well. It’s not the Medicare for All many Democrats have championed (https://voice.ons.org/advocacy/opioid-access-smoking-age-increase-house-medicare-for-all)—which is getting some pushback from conservative party members—but this bill is a way to retain elements of universal health insurance across the country. Most are doubtful it will pass in the Senate, but lines are being drawn for the 2020 presidential election cycle and health care still tops the list of voter interest (https://voice.ons.org/advocacy/candidates-position-will-matter-to-voters-especially-health-care)s. Scott’s change is more likely to succeed, but budgets are not binding documents. Ultimately, it looks like the healthcare debate is heating up again in Washington, DC.
Trump Faces Obstacles for Medicaid Work Requirements
Medicaid, originally designed to provide healthcare coverage to the country’s most impoverished and at-risk individuals, is facing a new battle as the Trump administration attempts to implement work requirements (https://thehill.com/policy/healthcare/436380-trump-hits-obstacles-in-effort-to-reshape-medicaid) for recipient to access medical benefits. Previous efforts to institute work requirements for federal services like Medicaid have been met with stiff resistance from patient advocacy groups and were struck down in courtrooms across the country (https://www.politico.com/story/2019/03/27/work-requirements-medicaid-1240074).
For patients with cancer, the physical toxicities associated with their diagnoses and treatments could affect their ability to work. This becomes especially difficult when compounded by issues like financial toxicity and the impact of high cost cancer care (https://voice.ons.org/news-and-views/financial-toxicity-and-its-burden-on-cancer-care). What would survivorship care look like for patients who are unable to work and rely on Medicaid for coverage? ONS will continue to work with lawmakers throughout the country to secure access to high quality care for patients with cancer (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy/position-statements/access-quality-cancer).