Obamacare ruling stirring fears of more court action

A federal court’s decision last week to strike down a key element of the Affordable Care Act could be the first step in the law’s gradual dissolution — a change that would affect thousands in Pennsylvania.

After a three-judge Court of Appeals on Wednesday panel struck down a major portion of the law — commonly called Obamacare — Pennsylvania officials warned that more could follow.

“The endless attempts to dismantle the Affordable Care Act have a destabilizing effect that creates confusion and insecurity among people who rely on this law,” Health and Human Services Director Teresa Miller said in a written statement. “People may go without coverage or care, which endangers their health and financial well-being.”

The court eliminated the individual mandate, a legal requirement to have some kind of qualifying health insurance. The mandate draws more people into insurance pools, offsetting the cost of sicker or more expensive patients.

The mandate has long been a target for the law’s opponents, including those in Congress and President Donald Trump’s administration. But last week’s court ruling sent the rest of the law back to a conservative lower court, raising the possibility of further cuts.

While no particular part of the law is guaranteed to remain or disappear, many provisions are on the table: access to parental insurance for those younger than 26, a ban on insurance companies icing out patients with “pre-existing conditions” and a popular Medicaid expansion in many states.

Pennsylvania’s Medicaid expansion — made possible by the Affordable Care Act — brought hundreds of thousands of residents into the government insurance program. Its elimination would have serious impacts, Miller warned.

“Because of this decision, health care remains in jeopardy for the nearly 700,000 Pennsylvanians who can access health care because of Medicaid expansion,” she said.

Administration officials said wholesale elimination of the law would eliminate insurance for some 1.1 million Pennsylvanians.

Nearly a decade after its passage, the Affordable Care Act remains a political minefield. While elected Republicans have tried repeatedly to overturn the law, some provisions — like the ban on insurers turning away sick patients — remain popular across the country.

Trump has vowed to protect those policies, saying in May: “We will always protect patients with preexisting conditions, very importantly.” But his administration backs the lawsuit that could strip away those protections.

The private insurance provided through the act has proven resilient, with Pennsylvania insurers gradually expanding their offerings. In the past, however, legal uncertainty has rippled across the system, affecting prices and policies for those who lack other insurance options.

The state Democratic Party put the risk bluntly on Thursday.

“Trump and Republicans are now one step closer to destroying our health care system,” party spokesman Andres Anzola wrote.

Senate readies for Trump trial

An evenly split Pennsylvania House delegation helped pass articles of impeachment against Trump last week, setting the stage for a contentious Senate trial. Trump is accused of abusing his power to investigate political enemies and obstructing a subsequent congressional inquiry.

Split 9-9, Pennsylvania’s House representatives divided along party lines in the impeachment vote — making Trump the third president to be impeached. He faces a trial in a friendly Senate, where Republicans are already making their feelings known.

“Today marks the culmination of a highly partisan process that achieved a longstanding goal of many House Democrats: impeaching President Trump,” Sen. Pat Toomey, R-Pa., said last week. “It is my hope that the process in the Senate will be fair, unlike the process in the House.”

While Toomey did not say outright that he will vote to acquit Trump, there is almost no chance the president will be removed from office. Senate Majority Leader Mitch McConnell, R-Ky., has said “I’m not impartial” while preparing for the trial.

Speaker of the House Rep. Nancy Pelosi, D-Calif., has so far withheld the articles from the Senate, in an apparent bid to negotiate new conditions for a future Senate trial. The procedures and timing of a trial remain up for discussion.

Both parties took a solemn tone after the vote, with Democratic lawmakers stressing the seriousness of their decision. Republicans like U.S. Rep. John Joyce, R-13th District, deny any crime was committed when Trump asked Ukrainian leaders to investigate presidential hopeful Joe Biden’s son.

“On this dark day for our nation, House Democrats impeached President Trump not for a crime, but simply because they do not like him and fear that he will be re-elected next year,” Joyce said.


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