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Trump Administration Moves Forward In Attempt To Invalidate Affordable Care Act


The Trump administration is going forward with an attempt to invalidate the Affordable Care Act. The Justice Department filed a notice that it supports a federal judge's ruling that the entire law should be thrown out. And joining us to talk about this is NPR health correspondent Alison Kodjak.

Hi, Alison.


GREENE: OK. So what exactly is the Justice Department saying this morning?

KODJAK: Well, the Justice Department filed this notice which basically says it agrees with the judge's opinion in this case, which was out of Texas. And it was a really expansive opinion that invalidated the entire Affordable Care Act, which is a huge law. Originally, the Justice Department had said it wanted parts of the law invalidated. And so this changes the Trump administration's position to sort of saying, this entire law has to go.

GREENE: So the fact that the Justice Department is filing this notice with, you know - supporting one federal judge's ruling - does it change anything at this moment in terms of the law and in terms of people covered under it?

KODJAK: No, it doesn't change anything immediately. Essentially, everybody who has insurance through the Affordable Care Act directly - which is about - well over 10 million people through Medicaid and another 10 or 11 million through the ACA exchanges - that all stays the same because this is a legal case that is going to wind its way through the courts and probably eventually get to the Supreme Court.

So there's a lot of still legal fighting going on. There is a group of state attorneys general, Republicans, who want the law repealed and overturned. And there is another group of state attorneys general from Democratic states who are fighting to keep the law in place.

GREENE: OK. So this sets the stage, though, for what could be, I mean, a monumental decision about Obamacare in the Supreme Court once again. And I guess my question is - were they to side with the Trump administration, throw this entire law out - I mean, I know this is looking down the road a bit - but what could that mean for the health care system?

KODJAK: You know, it's really amazing what that could mean 'cause the Affordable Care Act - most people think of it as these exchanges where people can buy insurance. Most people's objections to it had to do with the fact that there was this federal requirement that people buy health insurance, and they didn't like that.

But really, this law touches every part of the health care system. It determines how Medicare pays doctors. It creates this Medicaid expansion, which many states have taken on, which has covered millions of lower-income people. It determines things like whether restaurants have to post nutrition information. It really - it sets up different health care delivery systems for hospitals. It really touches everything. And if the law were repealed wholesale, it would change - hospitals would have to come up with new payment systems. An entire section of the insurance industry would go away. It's really pretty expansive.

GREENE: Any idea why President Trump and his administration would decide to do this now?

KODJAK: You know, I don't really know why they would do this now. What became clear during the midterms was that the Affordable Care Act became pretty popular among voters - and especially things like the protections for people with pre-existing conditions are very, very popular. So politically, trying to take this law away and really upend the whole health care system could be pretty tricky and dangerous politically for the Trump administration and for Republicans who support this legal case.

GREENE: All right. That's NPR health correspondent Alison Kodjak joining us this morning.

Alison, thanks. We appreciate it.

KODJAK: Thank you, David.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

David Greene is an award-winning journalist and New York Times best-selling author. He is a host of NPR's Morning Edition, the most listened-to radio news program in the United States, and also of NPR's popular morning news podcast, Up First.
Alison Fitzgerald Kodjak is a health policy correspondent on NPR's Science Desk.