As the Senate is poised to vote on Chad Readler’s nomination for the Sixth Circuit Court of Appeals, once again Republicans are about to show us where they stand: against Americans with pre-existing conditions and with a Trump administration that is resolved to dismantle the ACA. Readler, who overruled career Justice Department attorneys and filed the brief on behalf of the Trump administration in Texas v. United States arguing in favor of striking down protections for people with pre-existing conditions, is a known health care opponent. From patient groups to doctors, hospitals, and insurance companies, those who know health care the best say that Readler’s position on health care is the worst.
Leading up to the Texas hearing, disease groups, patient groups, doctors and hospitals warned that Readler’s argument to eliminate the Affordable Care Act and its consumer protections would have disastrous consequences:
Joint Statement From Five Disease Groups — American Cancer Society Cancer Action Network, American Diabetes Association, American Heart Association, American Lung Association, and the National Multiple Sclerosis Society: Patients May Be Forced To “Delay, Skip Or Forego Care.” “Should this case be successful, people with cancer, heart disease, diabetes, lung disease and any serious or chronic condition are likely to be denied coverage due to their pre-existing conditions or charged such high premiums because of their health status that they will be unable to afford any coverage that may be offered. Without access to comprehensive coverage patients will be forced to delay, skip or forego care. This was often the case before the law took effect and would likely be the same should these essential protections be eliminated…Striking down these provisions would be catastrophic and have dire consequences for many patients with serious illnesses.” [Joint Statement, 6/8/18]
Joint Statement From Six Provider Groups — American Academy of Family Physicians, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, American College of Physicians, American Osteopathic Association, and American Psychiatric Association: “The Elimination Of These Protections Could Result In Millions Of People Facing Limited Access To Health Care Coverage And Higher Cost As A Result Of Insurers Being Allowed To Return To Discriminatory Coverage And Pricing Practices.” “Our organizations, which represent a combined membership of more than 560,000 physician and medical student members are concerned about the Department of Justice’s decision to not defend the constitutionality of existing laws that extend patient protections to individuals in insurance markets as part of Texas v United States. The elimination of these protections could result in millions of people facing limited access to health care coverage and higher cost as a result of insurers being allowed to return to discriminatory coverage and pricing practices…As physicians who provide a majority of care to individuals for physical and mental conditions, we can speak clearly that these insurance reforms and protections are essential to ensuring that the more than 130 million Americans, especially the more than 31 million individuals between the ages of 55 and 64, who have at least one pre-existing condition are able to secure affordable health care coverage.” [Joint Statement on Texas v. United States, 6/9/18]
American Psychiatric Association: “This Decision Could Lead To Insurers Denying Coverage To The 130 Million Americans With Pre-existing Conditions…Is In The Midst Of An Opioid Epidemic And 30% Rise In Suicide Rates.” “This decision could lead to insurers denying coverage to the 130 million Americans with pre-existing conditions. This is harmful to the health of these Americans and is very short-sighted considering the nation is in the midst of an opioid epidemic and 30% rise in suicide rates.” [American Psychiatric Association, 6/8/18]
The Arc: “Another Example Of The Trump Administration’s Intent To Undermine Access To Health Insurance For Millions Of People With Disabilities.” “The actions of the Department of Justice are another example of the Trump Administration’s intent to undermine access to health insurance for millions of people with disabilities by dismantling the Affordable Care Act. It exposes the Administration’s intent to eliminate critical protections for people with pre-existing conditions who benefit from provisions in the law that assure access to affordable health insurance. The ongoing attempts to dismantle this law highlight a disturbing disregard, by the Trump Administration, for the needs of people with disabilities who rely on the Affordable Care Act for their health and wellbeing.” [The Arc, 6/8/18]
Brain Injury Association of America: People With Pre-Existing Conditions, Like A Brain Injury, Will Likely Lose Access To Essential Treatment And Rehabilitation. “The Justice Department’s position threatens a core piece of the Patient Protection and Affordable Care Act. If the court agrees, people with pre-existing conditions – like brain injury – will likely be forced to pay higher premiums and ultimately lose access to essential treatment and rehabilitation.” [Brain Injury Association of America, 6/8/18]
Margaret A. Murray, Chief Executive of the Association for Community Affiliated Plans: Anyone Who Has Had “So Much As A Case Of Asthma” Should Be “Deeply Unsettled.” Margaret A. Murray, the chief executive of the Association for Community Affiliated Plans, which represents plans for low-income and vulnerable populations, said that anyone who has bought individual insurance ‘and has had so much as a case of asthma in their past should be deeply unsettled by the choices this administration has made.’” [Washington Post, 6/8/18]
America’s Health Insurance Plans: Administration’s Decision Will Cause Rates To Increase For Older, Sicker Patients. “Zeroing out the individual mandate penalty should not result in striking important consumer protections, such as guaranteed issue and community rating rules that help those with pre-existing conditions. Removing those provisions will result in renewed uncertainty in the individual market, create a patchwork of requirements in the states, cause rates to go even higher for older Americans and sicker patients, and make it challenging to introduce products and rates for 2019.” [America’s Health Insurance Plans, 6/8/18]
After Judge Reed O’Connor ruled in favor of Readler’s argument, insurance companies, disease groups, hospitals, and health advocates yet again condemned the position, calling it “misguided and wrong”:
Blue Cross Blue Shield: “We Are Extremely Disappointed In The Court’s Ruling.” “Yesterday’s federal district court ruling in a case challenging the Affordable Care Act is the first step in what we expect will be a lengthy legal process…While we are extremely disappointed in the court’s ruling, we will continue to work with lawmakers on a bipartisan basis to ensure that all Americans can access the consistent, quality health coverage they need and deserve.” [Blue Cross Blue Shield, 12/15/18]
America’s Health Insurance Plans: “The District Court’s Decision Is Misguided And Wrong.” “The district court’s decision is misguided and wrong. This decision denies coverage to more than 100 million Americans, including seniors, veterans, children, people with disabilities, hardworking Americans with low-incomes, young adults on their parents’ plans until age 26, and millions of Americans with pre-existing conditions. We argued in an amicus brief before the court that provisions of the Affordable Care Act (ACA) affecting patients with pre-existing conditions, and those covered by Medicaid and Medicare should remain law regardless of what the court ruled on the individual mandate. Unfortunately, this ruling harms all of these Americans.” [AHIP, 12/14/18]
American Medical Association: “An Unfortunate Step Backward For Our Health System.” “The American Medical Association called the ruling ‘an unfortunate step backward for our health system’ and warned the decision could ‘destabilize health insurance coverage.’ ‘No one wants to go back to the days of 20 percent of the population uninsured and fewer patient protections, but this decision will move us in that direction,’ AMA president Barbara L. McAneny said in a statement.” [CNBC, 12/14/18]
American Federation Of Hospitals: “The Judge Got It Wrong.” “‘The judge got it wrong,’ said Charles N. ‘Chip’ Kahn III, president of the Federation of American Hospitals. ‘This ruling would have a devastating impact on the patients we serve and the nation’s health-care system as a whole. . . . Having this decision come in the closing hours of open enrollment also sows seeds of unnecessary confusion.’” [Washington Post, 12/14/18]
American Hospital Association: “America’s Hospitals And Health Systems Are Extremely Disappointed.” “America’s hospitals and health systems are extremely disappointed with today’s federal district court ruling on the constitutionality of the Affordable Care Act. The ruling puts health coverage at risk for tens of millions of Americans, including those with chronic and pre-existing conditions, while also making it more difficult for hospitals and health systems to provide access to high-quality care…We join others in urging a stay in this decision until a higher court can review it and will continue advocating for protecting patient care and coverage.” [American Hospital Association, 12/14/18]
American Association of Medical Colleges: “This Ruling Puts Millions Of Americans, Including The Most Vulnerable Patients, At Risk.” “Dismantling the ACA will be disastrous for the nation’s health care system. Patients—particularly those with preexisting and complex conditions—require stability and continuity in their care. Without access to affordable meaningful coverage, many would forego or delay necessary medical care. This ruling puts millions of Americans, including the most vulnerable patients, at risk.” [American Association of Medical Colleges, 12/15/18]
Elena Hung, President Of Little Lobbyists: “The Harm Is Done.” “We know the ACA is still the law and nothing changes for now. But the harm is done; you can’t tell us not to worry when our kids’ lives are on the line.” [Elena Hung Twitter, 12/14/18]