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Court battle over Affordable Care Act could affect millions of New Yorkers

Texas Attorney General Ken Paxton.

Texas Attorney General Ken Paxton. Credit: Austin American-Statesman/Nick Wagner

A federal court hearing in Louisiana on Tuesday could have major ramifications for the 4.7 million New Yorkers who obtained health care coverage through the state's marketplace.

A lawyer for the Texas Attorney General's office will be in federal court asking three appellate judges to declare the Affordable Care Act unconstitutional, and this time it will be with the full support of the Trump administration.

The U.S. Department of Justice earlier this year announced that the agency believes the entire law should be struck down, reversing its previous position that certain sections, including a provision allowing states to expand Medicaid, should not be affected by the case.

Opposing them in Tuesday’s oral arguments at the 5th U.S. Circuit Court of Appeals in New Orleans will be lawyers for the U.S. House and 20 Democratic-led states who say striking down the law would wreak havoc on the health care system and put lives at risk.

The showdown will produce a decision that could give the U.S. Supreme Court another crack at deciding whether the 2010 law, a signature achievement of Democratic President Barack Obama, remains in effect.

At stake is health insurance for about 20 million Americans, either directly through the program sometimes called Obamacare or through expanded Medicaid coverage, as well as protection for millions more who have preexisting medical conditions.

More than 4.7 million New Yorkers were enrolled in coverage through NY State of Health as of Jan. 31, an increase of more than 435,000 people from 2018. New York has seen a significant corresponding reduction in the number of uninsured from 10 percent in 2013, when the marketplace opened, to below 5 percent in 2019, according to state data.

The increased enrollment is "proof that demand remains high for affordable and comprehensive health coverage,” a spokeswoman for the state Department of Health said Monday. "New York remains committed to providing access to affordable health insurance for New Yorkers."

The chief executive of the largest health system on Long Island on Monday expressed concern over the case.

"While the Affordable Care Act has underlying flaws, continued effort to repeal the health law without a concrete replacement plan that provides equivalent coverage is a gambit that threatens lives," said Michael J. Dowling, president and CEO of Northwell Health, the largest private employer in the state. "Sadly, there will be millions of victims if we continue down this dangerous path. Despite some flaws, the U.S. health care system — with all of its complex and interdependent parts — has been dramatically successful in saving and prolonging lives.”

Texas Attorney General Ken Paxton, a conservative Republican who calls Obamacare an improper expansion of federal power into the health care system, gathered 17 other GOP-led states into a coalition that filed suit in February 2018 to overturn the ACA.

Leading the fight to preserve the law is California Attorney General Xavier Becerra, a Democrat who believes Paxton and others are deluded if they think a gridlocked Congress — where Republicans have tried and failed more than 70 times to repeal the Affordable Care Act — could fill the void if Obamacare is struck down.

Becerra called the legal challenge a dangerous and reckless move.

Striking down the law also would threaten those under age 26 who are covered under a parent’s health plan, 12 million seniors with prescription drug benefits under Medicare and families that rely on tax credits and employer-sponsored plans to afford insurance, Becerra said.

Paxton’s case against the Affordable Care Act focuses on the Trump tax cuts of 2017, when Congress eliminated the tax penalty under the law’s individual mandate, a provision that requires most Americans to have some form of health insurance.

According to Paxton, when the U.S. Supreme Court upheld the law in 2012, it did so because the individual mandate was a proper use of congressional taxing authority. With the penalty stripped out, there is no legal basis for the act, he said.

“Congress meant for the individual mandate to be the centerpiece of Obamacare. Without the constitutional justification for the centerpiece, the law must go down,” Paxton said.

— With Tribune News Service

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