Department of Justice’s refusal to defend ACA jeopardizes coverage for millions of Pennsylvanians and creates confusion for regulators, insurers and patients
HARRISBURG – Today, Pennsylvania Attorney General Josh Shapiro sent a letter requesting clarification from United States Attorney General Jeff Sessions regarding the Trump Administration’s position on enforcing key provisions of the ACA, including protecting those with preexisting conditions and preventing discriminatory pricing.
The letter from Attorney General Shapiro comes after contradictory statements were issued from the United States Department of Justice (DOJ) and the United States Department of Health and Human Services (HHS) regarding the constitutionality of certain ACA provisions and how the program would operate in 2019.
“Pennsylvanians need assurance now that the vital protections guaranteed under the ACA will not be taken from them,” wrote Shapiro. He goes on to say that in addition to the millions who have benefited from increased coverage, “up to 5.4 million Pennsylvanians with preexisting health conditions no longer worry about being denied coverage,” leading to the lowest uninsured rate for the Commonwealth on record.
In a recent filing by the DOJ in Texas et al. v. United States et al., the Department chose not to defend these key provisions in the ACA. Similarly, in a letter to Congressional leaders in June, Sessions advised that the DOJ will no longer defend the constitutionality of the ACA’s individual mandate and that the ACA’s requirement that insurers offer coverage to any customer who wishes to purchase it would become invalid as of January 1, 2019.
“Your refusal to defend them in court jeopardizes the coverage of millions of Pennsylvanians,” wrote Shapiro to Attorney General Sessions.
Further complicating the Administration’s position, after the statements from Attorney General Sessions, HHS Secretary Alex Azar responded to a question from U.S. Senator Bob Casey in testimony before the Senate Finance Committee by saying HHS may continue to enforce the provisions. “We are operating the 2019 program under existing authority… doing everything to keep stability in the program and operate the program as it is,” he answered.
The Pennsylvania Insurance Department is currently reviewing health insurance plans to be offered in 2019 and proposed rates for those plans. The rate review process must be completed by August 15, 2018, and open enrollment for 2019 plans begins on November 1. These conflicting statements have created significant confusion in the insurance marketplace in Pennsylvania.
Attorney General Shapiro in his letter to Sessions clearly notes this discrepancy and calls for clear answers in a timely manner. “Secretary Azar’s position appears to conflict with yours, creating confusion for regulators, insurers and patients alike… In order to ensure that Pennsylvania residents and regulators have sufficient time to prepare for the 2019 plan year, kindly provide your response no later than July 31, 2018.”
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