Trump's Refusal to Defend ACA Abandons Millions of Americans
The recent decision not to defend critical components of the Affordable Care Act (ACA) in legal challenges brought by the state of Texas is the latest sign that Trump and his administration are willing to abandon millions of Americans living with chronic or pre-existing conditions. These Americans suffer from diagnoses including HIV, hepatitis, and other STDs, and they rely on the ACA for access to critical, affordable health care coverage.
In a suit filed in federal court earlier this year, Texas claimed that when Congress eliminated the penalty associated with the individual mandate, it made the mandate itself unconstitutional. In its brief filed with the court on June 7, the Department of Justice (DOJ) agreed with this view that the individual mandate is indeed unconstitutional. And if eliminated, it argued, two provisions of the law that offer protections for people with pre-existing conditions — specifically, the guaranteed issue and community ratings provisions — must also go.
Having failed repeatedly to repeal the ACA last year, this decision is the latest tactic in the Trump administration’s new health care playbook: stripping the law of so many essential components that it collapses under its own dysfunction.
The potential effects of the administration’s new position cannot be overstated. If implemented, the actions proposed by the DOJ’s court filings would gut health care reform and wreak havoc on insurance markets. In so doing, the administration would rip health care from millions of Americans, including those who voted for the president. Instead of fighting for the well-being of his own constituents, President Trump is fighting to strip them of their protections from health insurer discrimination and possible denial of coverage based on pre-existing conditions.
It is all too clear that the administration cares more about partisan politics than protecting the gains we’ve made in expanding access to healthcare in this country. If the president would reach across the aisle to find areas of agreement and improve the law, real progress could be made to ensure that all Americans have access to quality and affordable care, while still supporting businesses and saving billions of dollars in government spending.
Last month, the administration released a report on the progress made in achieving the goals of the National HIV/AIDS Strategy, which it claims is evidence of an ongoing commitment to improving the well-being of Americans. Unfortunately, the administration’s decision in this case undermines that claim, as does every effort to dismantle health care reform that this administration has made. We will never realize the vision outlined in the strategy or end this epidemic without the reforms that so significantly expanded health care coverage to people living with or at risk for HIV.
For years, politicians and policymakers have talked big about the realization of an “AIDS-free generation” and an end to the HIV epidemic. In this regard, the Trump administration is no different. But while biomedical advances have given us tools that could help us end the epidemics of HIV, STDs, and viral hepatitis, these advances will do nothing without concrete policy changes behind them. Reforming our criminal justice system, transforming our approach to substance abuse and dependence to incorporate harm reduction principles, and ensuring that everyone, regardless of income or status, has unfettered access to health care are all essential to the fight against these epidemics.
It’s time for this administration to abandon its ongoing and ill-guided efforts at taking health care away from those who need it most. That crusade has not and will never make America great. We urge the administration to reconsider its decision and to vigorously defend the ACA against any and all court challenges.
Jesse Milan, Jr. is president and CEO of AIDS United. Paul Kawata is executive director of NMAC.
