Welp. The idiotic #TexasFoldEm lawsuit against the ACA...or more specifically, the Trump Administration's decision to lay down and even join the lawsuit against it--appears to be doing even more damage to the U.S. Justice Department than I had thought:

In addition to three nonpartisan Justice Department attorneys withdrawing from the case just minutes before the government's brief in the case was formally filed (presumably in protest of the decision by their boss), a highly-respected senior attorney with the Department has also resigned in protest:

A highly respected career lawyer at the Justice Department has decided to resign just days after the Trump administration backed a controversial lawsuit that would wreck part of the Affordable Care Act.

About 90% of my focus here at ACASignups.net is on the two biggest sections of the ACA: The Individual Market (3-legged stool, exchanges, subsidies, etc.) and Medicaid expansion. I tend not to write much about Medicare, "traditional" Medicaid or the Employer-Sponsored Insurance (ESI) market, which mainly consists of the Large Group Market (companies with 50 employees or more) and the Small Group Market (companies with fewer than 50 employees). As it happens, the ESI market covers nearly half the U.S. population (roughly 155 million Americans, give or take).

Under the ACA, individual market policies have to include the following "Blue Leg" provisions to be considered ACA-compliant:

 

(Image via "Turtle Fart w/Loud Lord" on SoundCloud)

This is utter horseshit:

McConnell on Trump’s decision to support the Texas lawsuit that would invalidate Obamacare:

"Everybody I know in the Senate, everybody, is in favor of maintaining coverage for preexisting conditions. There's no difference in opinion about that whatsoever."

— Sahil Kapur (@sahilkapur) June 12, 2018

Even if you ignore the multiple times over the years that he's promised (and voted) to "defund Obamacare" and "repeal it out root & branch"...

...there's still the matter of last year, when Senate Republicans introduced the "Better Care Reconciliation Act plan" (BCRAp), which looked something like this:

 

By far, the most popular provisions of the Affordable Care Act is that it mandates Guaranteed Issue (GI) and Community Rating (CR) rules to all major medical healthcare insurance policies in most of the United States (all 50 states, plus DC...most ACA provsions don't apply in Puerto Rico, Guam and other U.S. Territories). These provisions state, quite simply, that insurance carriers can no longer discriminate against enrollees based on their physical or mental health status or history, their gender and so on, and can therefore no longer use medical underwriting to either cherry-pick who their enrollees are or how much they're charged in premiums for a given policy.

This is about as simple as I could make it. It's an absolutely absurd argument, but there it is:

 

It's time once again to talk about stools. Not step stools, but the Three-Legged Stool.

I posted this video explainer about the Affordable Care Act's "Three-Legged Stool" works last winter. The first 9 minutes or so covers why it exists, how it's supposed to work, how well it's actually working, the most obvious problems with it and the basics of how to fix them. The second half goes into the details of the half-dozen different awful repeal/replace bills that Congressional Republicans tried to push through throughout 2017.

Below is a condensed transcript version of the first half of the slideshow.


First of all, who is in the Individual Market? Well, what you're looking at right now is something a friend of mine dubbed The Psychedelic Donut. It's actually a depiction of the healthcare coverage, by type, of the entire U.S. Population...all 320 million or so of us.

One of the big stories over the past few months has been the Trump Administration's attempts to strip away regulations on non-ACA compliant "Short-Term, Limited Duration" plans (by making them neither short-term nor of limited duration) and "Association Health Plans" (by recategorizing them from state-regulated, Small Group plans to mostly unregulated Large Group plans).

However, a couple of months ago I wrote about a brand-new law in Iowa which would take a third route towards skirting ACA compliance: Farm Bureau plans:

The Iowa Senate voted Wednesday to let the Iowa Farm Bureau Federation and Wellmark Blue Cross & Blue Shield sell health insurance plans that don't comply with the federal Affordable Care Act.

The new coverage could offer relatively low premiums for young and healthy consumers, but people with pre-existing health problems could once again be charged more or denied coverage.

 

(*credit to Nicholas Bagley for coining "Texas Fold'em")

Ut-oh. I've only written one blog post about this one (back in February) because the argument behind it is so idiotic that it actually makes King vs. Burwell seem like Marbury v. Madison by comparison.

Here's the short version:

Texas is suing the federal government over President Barack Obama's landmark health law — again.

In a 20-state lawsuit filed Monday in federal court, Attorney General Ken Paxton argued that after the passage of the GOP's tax plan last year — which also repealed a provision of the sweeping legislation known as "Obamacare" that required people to have health insurance — the health law is no longer constitutional.

NOTE: The original post was getting to long/unwieldy so I've separated out my initial analysis of the proposal into this separate post.

Yesterday, Michigan Democratic Gubernatorial candidate Abdul El-Sayed publicly rolled out his vision for a state-based Single Payer healthcare system. I wrote up an overview yesterday. Below are my initial thoughts, based on reading both the summary and full version of the proposal as presented on El-Sayed's website.

UPDATE 4:30pm: (sigh) As I expected, the stripped-down version of SB897 passed the state House

SB 897, to impose Medicaid work requirements, passed the House 62-47. #mileg

— Lindsay VanHulle (@LindsayVanHulle) June 6, 2018

The revised version of the bill still has to be kicked back over to the state Senate for a final vote, but that's almost certain to pass, so the only thing stopping it at this point is the possibility of Gov. Rick Snyder vetoing it, which is what I figured it would come down to in the the first place.

UPDATE 6/11/18: So much for that prospect:

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