Obamacare Critics and Defenders Team Up Against the Trump Administration's Refusal to Defend the Health Law in Court
The DOJ's argument for striking down the health law's preexisting conditions rules is weak.
Last week, in response to a legal challenge filed by Texas and a group of conservatives states, the Trump administration took an unusual step by announcing that it would not defend Obamacare in court. Instead, the Trump administration took the position that the health law's was unconstitutional, and that its preexisting conditions regulations should be struck down.
The federal government's suit has drawn rebuke from some unlikely quarters. An attorney with 20 years of experience at the Justice Department resigned this week as a result of the administration's position. Sen. Lamar Alexander (R-Tenn.) said it was "as far-fetched a legal argument as I think I've ever heard." Senate Majority Leader Mitch McConnell distanced his party from the argument, saying that "everyone" in the Senate favored maintaining coverage for people with preexisting conditions.
Even Health and Human Services (HHS) Sec. Alex Azar, who signed the brief in question, described it as a "constitutional and legal position, not a policy position."
It doesn't appear to be much of one.
Among the more unusual responses to the administration's argument came today in the form a brief filed by five academic experts with wildly divergent views about Obamacare. The brief is signed by Jonathan Adler, Nicholas Bagley, Abbe Gluck, Ilya Somin, and Kevin Walsh. Bagley and Gluck have both defended the health law's legality in the past. Walsh has published several analyses of the legal arguments surrounding Obamacare. But Adler and Somin, notably, are libertarian-leaning law professors who have been quite critical of the health law over the years. (Both are also contributors to the Volokh Conspiracy, which is published at Reason.com.)
The opening of the brief stresses that the signers have spent the last several years disagreeing with each other, in some cases quite forcefully, about the legal and constitutional merits of the health law. The brief takes no position on the mandate itself. But in this case, they all agree that the federal government's argument for striking down the law's preexisting rules is, legally speaking, pretty terrible.
Understanding the brief requires a little bit of background. In 2012, the Supreme Court ruled that although Obamacare's mandate was unconstitutional when viewed as a purchase requirement or economic command, it could stand because it raised revenue and therefore functioned as a tax. But last year, as part of tax reform legislation, Congress eliminated the penalty for not complying with Obamacare's individual mandate. The mandate remained on the books, but for all practical purposes it had been repealed. And it no longer raised any revenue.
As a result, a group of conservative states, led by Texas, challenged the legality of the (now unenforceable) mandate, and further argued that because it is the centerpiece of the health law, all of Obamacare should be struck down.
This is an argument about what's known as "severability" — whether the remaining parts of a law should be struck down if a court finds one provision to be illegal.
The Trump administration's argument does not go quite as far as the states. It agrees that the mandate is now unconstitutional, and takes the position that although much of the law, including the Medicaid expansion and private insurance subsidies, can stand, the preexisting conditions rules should be tossed along with the mandate, because the mandate and the preexisting conditions rules are not severable. To back up its argument, the administration cites findings associated with the statute of Obamacare (that were also cited by the Obama administration in court) declaring that the mandate and the preexisting conditions rules are a bundle that should not be separated.
For critics of Obamacare, there is something naturally appealing about this argument: It uses the text of the health law, and the Supreme Court's decision to uphold it, to attempt to knock it down. I have been open to arguments along these lines under the Obama administration, and I think they made sense at the time.
The problem, as the new brief points out, is that determining severability is about determining congressional intent. And the current Congress has made its position on the matter quite apparent. Often, this requires some sort of guessing. But at this point, we know exactly what Congress thinks about the law it chose to amend, because it very clearly chose to eliminate the mandate penalty while leaving the preexisting conditions rules in place. That is about as clear a statement of intent as you can ever imagine from Congress.
The brief argues that the administration's argument relies on "time shifting" to make its case, and that the administration's case effectively gets severability backward by "[disregarding] the clearly expressed intent of Congress and seek judicial invalidation of statutory provisions that Congress chose to leave intact."
The findings about severability that the administration cites to back up its arguments about the preexisting were made by a different Congress, prior to the elimination of the mandate penalty and other alterations to the law. They were made in the context of what is now, essentially, a different law. They don't apply.
I have been a critic of Obamacare for years, and I continue to believe there are many problems with the law. The preexisting conditions rules, while popular, distort the individual market and have contributed to rising premiums in the exchanges. (The popularity of those rules, of course, is one reason why Republicans haven't touched them, and why GOP officials are distancing themselves from the policy implications of their argument.) But critics of the health law do themselves no favors by signing on to a fundamentally weak legal challenge like this.
The bigger problem with this case is that it has the potential to serve as a substitute for a policy agenda. Republicans still need a broad health policy vision that goes beyond simply attacking Obamacare. But as long as they are basing their hopes on a legal manuever as poorly thought out as this one, that's not something we're likely to see.
