Patient advocates, health care groups sue Trump administration to preserve insurance protections
By NOAM N. LEVEY | Los Angeles Times | Published: September 15, 2018
WASHINGTON (Tribune News Service) — Opening yet another legal battle over the Affordable Care Act, a coalition of patient advocates and other health care groups is going to court to try to block the Trump administration from expanding the availability of short-term health plans that don't offer a full set of benefits.
The lawsuit, filed Friday in federal court in Washington, seeks to blunt one of the signature moves by the administration to weaken patient protections enacted through the 2010 health care law, often called Obamacare.
It accuses Trump's Treasury, Labor and Health and Human Services secretaries of jeopardizing access to life-saving medical care for millions of Americans with serious medical conditions, including mental illness, cancer and HIV/AIDS.
"It will be more expensive, and perhaps impossible, for some individuals with preexisting conditions to obtain health care and health insurance coverage – undermining the purpose of, and congressional plan embodied in, the ACA," the lawsuit argues.
The administration finalized new regulations last month designed to allow insurance companies to sell more short-term plans. That fulfilled a pledge by the president to loosen insurance rules that Republicans say have driven up premiums for consumers who don't get health coverage through an employer or a government health program such as Medicare or Medicaid.
The controversial move – which came on the heels of the unsuccessful campaign last year by congressional Republicans to repeal the health care law – will allow people who buy skimpier short-term plans to keep them for as long as three years, up from the previous limit of three months.
Administration officials have billed these plans as what Health and Human Services Secretary Alex Azar called "a much more affordable option for millions of the forgotten men and women left out by the current system."
But the short-term plans have been almost universally panned by patient advocacy organizations, leading physician and hospital groups, health insurers and many state regulators. They have warned that skimpier plans, while possibly less costly, will not provide consumers with the coverage they need if they get sick.
Expanding short-term plans also risks driving up costs for Americans with preexisting medical conditions who need more comprehensive benefits.
A central goal of the 2010 health care law was to guarantee coverage to Americans even if they were sick. It ended the long-standing practice by health insurers of charging higher premiums to consumers with preexisting medical conditions.
An important tool in ensuring equal treatment for all consumers was mandating that health plans cover a basic set of benefits, including prescription drugs, mental health services and maternity care.
Most patient advocates believe short-term plans undermine those key protections.
"This rule change rolls back the clock on Congress' bipartisan efforts to ensure patient protections and fair insurance coverage of mental illness – and will start a downward spiral that leaves people with mental health conditions right back to where we were, excluded from life-saving health care," said Mary Giliberti, chief executive of the National Alliance on Mental Illness, one of seven organizations that filed the lawsuit.
The other plaintiffs are the Assn. for Community Affiliated Plans; Mental Health America; the American Psychiatric Assn.; AIDS United; the National Partnership for Women and Families; and Little Lobbyists, a group that represents families of children with serious illnesses.
Earlier this year, a Los Angeles Times analysis of official comments filed with federal agencies before the final regulation was issued found more than 98 percent – or 335 of 340 – of the health care groups that commented on the proposal criticized it, in many cases warning that the rule could gravely hurt sick patients.
A second Trump administration proposal to make it easier for individuals and small businesses to band together to form so-called association health plans – which also don't have to offer a full set of health benefits – was similarly panned.
More than 95 percent of the 279 health care groups that filed comments about the proposed association health plan regulation expressed serious concern or opposed it.
Among the groups that have opposed the Trump administration's moves are virtually every leading patient advocacy organization in the country, including the American Lung Assn., the American Heart Assn., the Cystic Fibrosis Foundation, the March of Dimes, the National Multiple Sclerosis Society, Susan G. Komen, AARP and the advocacy arm of the American Cancer Society.
The Trump administration finalized the association health plan regulation earlier this summer.
A group of 12 Democratic attorneys general, including California's and New York's, are suing in another federal court to try to stop that regulation.
Opponents of the law are also in court, as 20 Republican governors and state attorneys general have filed a suit that seeks to invalidate the entire health care law.
The Trump administration has elected not to defend the law against that legal challenge, instead backing an argument by the GOP plaintiffs that core consumer protections in the law, including the ban on insurers turning away sick consumers, should be scrapped.
A federal judge in Texas heard arguments in that case earlier this month.
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