Trump administration move could take away coverage for preexisting conditions

Democrats are coming out swinging against the Department of Justice's move to back a lawsuit brought forth by a group of Republican attorneys general against the Affordable Care Act that, if successful, could result in the dismantling of some of the most significant parts of the health care law.

The Senate's top Democrats fired off a letter to President Trump on Friday to denounce the decision and urged Trump's Justice Department to reverse course.

"Mr. President, it is time to stop the sabotage. We are a country of laws, and the law must be respected, defended and enforced regardless of the person occupying the Oval Office," the senators wrote.

The letter was signed by Sens. Chuck Schumer of New York, Dianne Feinstein of California, Patty Murray of Washington, and Ron Wyden of Oregon.

The Texas-led lawsuit filed earlier this year claims that Congress’ decision to eliminate the individual mandate penalty, which goes into effect in 2019, should render the entire health care law invalid.

“Once the heart of the ACA—the individual mandate—is declared unconstitutional, the remainder of the ACA must also fall,” the lawsuit alleges.

In a court filing late Thursday, the Trump administration is specifically urging the Texas federal court to strike down two provisions from the ACA: one that requires insurers to cover people with pre-existing conditions, and the other that prevents insurers from charging individuals a higher premium because of their pre-existing condition.

Attorney General Jeff Sessions claimed it's “because otherwise individuals could wait until they become sick to purchase insurance, thus driving up premiums for everyone else.”

But the administration said the rest of the law, including Medicaid expansion, can remain in place.

"The American public widely supports retaining protections for pre-existing conditions. We implore you to listen to the voices of career Justice Department lawyers, as well as concerned families, patients, doctors and hospitals that want to retain these protections, and start working with Democrats to strengthen our health care system instead of trying to tear it down," the senators said in their letter to Trump.

California Attorney General Xavier Becerra is vowing to fight the move in court.

“The lawsuit initiated by Texas is dangerous and reckless and would destroy the ACA as we know it. It would leave millions of Americans without access to affordable, quality healthcare. It is irresponsible and puts politics ahead of working families,” Becerra said in a statement.

“We won’t sit back as Texas and others try yet again to dismantle our healthcare system. Our coalition of states and partners across the country will fight any effort to strip families of their health insurance," he said.

Becerra estimated that the states that back the health care law could lose half a trillion dollars in health care funding if the suit is successful. In April, he and 16 attorneys general sought to intervene in the federal lawsuit. The motion to intervene was granted last month.

If the Trump administration’s argument prevails, insurers could once again be able to deny Americans health insurance based on their health status.

“This is disgusting but not surprising. A year and a half into sabotaging Americans’ health care, this may be President Trump’s meanest effort yet – he is working to let insurance companies refuse to cover sick people," Sen. Chris Murphy, D-Conn., said in a statement. "Think about that for a minute – the president of the United States is actively working to give corporations the power to tell moms, dads and kids that they can’t get the health care they need to stay alive. And Republicans in Congress are letting him do it."

"The entire point of insurance is that it should be there when you need it. No one in Connecticut – or anywhere – should have to fear that they or their loved ones will be kicked to the curb and refused care when they need it most. The White House needs to hear that the American people will not stand for this,” Murphy said.

According to healthcare.gov, a pre-existing condition is a health problem a person has before enrolling in a new health care plan.

Epilepsy, cancer, diabetes, lupus, sleep apnea, and pregnancy are all examples of pre-existing conditions.

Mental disorders, including depression and anxiety, are also considered pre-existing conditions.

In a blistering statement, the American Psychiatric Association is calling on the administration to reverse its decision.

“We strongly condemn the Administration’s decision not to defend the patient protections provided in the Affordable Care Act, an established law of the land,” APA President Altha Stewart, M.D. said.

“In particular, this decision could lead to insurers denying coverage to the 130 million Americans with pre-existing conditions. This is harmful to the health of these Americans and is very short-sighted considering the nation is in the midst of an opioid epidemic and 30% rise in suicide rates. We call upon the Administration to reverse this decision and defend the rights of our patients," Stewart said.

The National Institute of Mental Health estimates that more than 16 million Americans suffer from depression each year.

Republicans in Congress have tried endlessly to the repeal the Affordable Care Act since it was signed into law in 2010 by President Barack Obama. They were successful in repealing the individual mandate that requires all Americans to have health insurance after it was included in the GOP’s tax reform legislation that Trump signed into law in December.

But some moderate Republicans, including Sens. Lisa Murkowski of Alaska and Susan Collins of Maine, previously helped tank Republicans' efforts to repeal and replace the ACA citing their concerns over the possible elimination of coverage for people with pre-existing conditions.

Collins slammed the administration's decision in a statement provided to ABC News.

"While much about health care is complicated, one thing is clear as we move forward: both parties need to work together to address the instability and high costs plaguing our health care system," Collins said.

"This announcement from the Administration does nothing to ameliorate the current system’s instability or foster cooperation toward a solution to lower premiums and increase choices for consumers. Instead, it exacerbates our current challenges and creates further uncertainty that could ultimately result in higher costs for millions of Americans and undermine essential protections for people with pre-existing conditions, such as asthma, cancer, heart disease, arthritis and diabetes," she said.

In a letter to House Speaker Paul Ryan, Sessions acknowledged that the executive branch typically defends existing federal law, but he concluded that this is a “rare case where the proper course is to forgo” defense of the individual mandate.

Senate Democrats have vowed to make health care policy a priority this summer, as they gear up for midterm elections this November.

The shift to health care is a notable strategy by which Democrats are hoping to remind American voters that Republicans are “deliberately sabotaging” the health care system, as Schumer put it in a letter he wrote to Senate Majority Leader Mitch McConnell earlier in the week.

“President Trump promised the American people health care that is “far less expensive and far better.” Unfortunately, today the situation is far worse,” Schumer wrote. “After 18 months of trying to repeal the Affordable Care Act and deliberately sabotaging our health care system, Republican policies have resulted in major premium increases for millions of Americans. This sabotage also has those with pre-existing conditions once again facing the prospect of denied coverage, increased costs, and medical bankruptcy.”