6 medical groups urge DOJ to reconsider ACA decision

The American College of Physicians, the American Academy of Pediatrics and four other medical associations, which together represent 560,000 physicians and medical students, are urging the U.S. Department of Justice to reconsider its decision not to defend key parts of the ACA.

A group of 20 states filed a federal lawsuit against the federal government in February, claiming the ACA's individual mandate requiring most Americans to purchase insurance or to pay a penalty tax — which the U.S. Supreme Court previously upheld in a 2012 decision — is now unconstitutional because the tax penalty is no longer in effect after being repealed as part of the 2017 tax bill. The states also argued ACA provisions guaranteeing coverage for people with pre-existing conditions cannot be separated from the mandate and should therefore be invalidated.

In a June 7 brief, the DOJ argued those two provisions of the ACA are unconstitutional.

The six medical organizations urged the DOJ to reconsider its decision not to defend those provisions because doing so may result in millions of people facing limited health coverage.

"The elimination of these protections could result in millions of people facing limited access to healthcare coverage and higher cost as a result of insurers being allowed to return to discriminatory coverage and pricing practices," the organizations said in a June 9 statement. "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."

Several insurers have also voiced concerns regarding the potential repeal of those protections, stating the end of those provisions may destabilize the individual insurance market.

"Millions of Americans rely on the individual market for their coverage and care, and they deserve affordable choices that deliver the value they expect. Initial filings for 2019 plans have shown that, while rates are higher due to the zeroing out of the individual mandate penalty, the market is more steady for most consumers than in previous years, with insurance providers stepping in to serve more consumers in more states," America's Health Insurance Plans said in a statement.

AHIP represents several insurers that sell individual coverage on and off the ACA's public exchanges, including Centene, Oscar Health and several Blue Cross and Blue Shield plans.

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