Texas Fold'em

Yesterday, the Trump Administration formally submitted their official brief with the Supreme Court of the United States asking SCOTUS to completely and fully strike down the entire Patient Protection & Affordable Care Act. This is the latest development in the utterly insane "California vs. Texas" lawsuit (formerly "Texas vs. U.S.", "Texas vs. Azar", or as I prefer to label it, "Texas Fold'em", a name originally coined by U of M law professor Nicholas Bagley but which doesn't seem to have caught on with anyone other than me so far.

I've written about this completely absurd lawsuit more times than I care to remember, but as a reminder, here's what it comes down to.

The image below is the "3-legged stool" of the Affordable Care Act.

The blue leg represents the various patient protections which the ACA requires health insurance carriers to provide--guaranteed issue, community rating, essential health benefits and so on.

via Sam Brodey of The Daily Beast:

The worsening coronavirus outbreak may be stretching the limits of the U.S. health care system and overwhelming state governments, but that isn’t deterring a group of 18 state attorneys general from plowing ahead with a lawsuit that could overturn the Affordable Care Act within a year—a move that could disrupt the health care system at a time of deep crisis. 

This fall, Texas Attorney General Ken Paxton is slated to argue in the U.S. Supreme Court on behalf of 17 Republican attorneys general—and against 21 Democratic attorneys general—that Obamacare is unconstitutional and must be struck down immediately.

Last May, New Jersey Democratic legislators were pushing through over a dozen bills which would effectively lock in nearly all of the ACA's "Blue Leg Protections", as I refer to them, at the state level. The main reason for this, of course, is to replicate federal ACA protections for enrollees just in case the U.S. Supreme Court does ultimately strike down the Affordable Care Act (or at least strikes down the consumer protection parts of it).

Well, I kind of lost track of the status of those bills over the summer and fall, but apparently most of them passed through both the New Jersey state House and Senate because just moments ago, NJ Governor Phil Murphy issued the following press release:

via the official CNN Democratic Debate Transcript (Part 1, Part 2)

PHILLIP: Let's turn to health care, the top issue for Iowa Democrats. Donald Trump is trying to repeal Obamacare, including the protections for pre-existing conditions. We all know that each of you vigorously opposes that. Still, there are some questions about what each of you would do.

This was the only time throughout the entire healthcare portion of the debate that anyone said a peep about the Texas vs. Azar lawsuit...and it wasn't even one of the candidates; it was the moderator.

Senator Sanders, you have consistently refused to say exactly how much your Medicare For All plan is going to cost. Don't voters deserve to see the price tag before you send them a bill that could cost tens of trillions of dollars?

 

With the Texas vs. Azar lawsuit (aka #TexasFoldEm) dangling over everyone's heads like the Sword of Damocles, Kaiser Family Foundation CEO Drew Altman has a short piece up over at Axios which notes that the sick irony of this whole stupid situation is that the ACA itself is clearly doing at least reasonably well without the mandate penalty being in place anyway...completely undermining the entire case of the plaintiffs in the lawsuit:

The ACA is doing fine without a mandate penalty

The Affordable Care Act’s insurance market has not been materially affected by the elimination of the individual mandate penalty — undercutting a key argument in the lawsuit urging the courts to strike down the health care law.