Maryland Sues to Save the ACA as Texas Judge Weighs Killing It

One question is whether the individual mandate can be separated from other ACA provisions.

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Maryland Attorney General Brian Frosh launched a counterattack Thursday to save the Affordable Care Act (ACA) as a Texas federal judge contemplates killing it.

Frosh sued the federal government in a Greenbelt, Maryland, court seeking a declaratory judgment that the ACA is constitutional and a court order barring the U.S. from taking any action inconsistent with that conclusion.

(Related: Trump Administration Fears `Chaos’ If ACA Provisions Blocked Too Soon)

The Maryland suit lands one week after the Trump administration told Fort Worth federal judge Reed O’Connor it has no qualms about his striking down the act, only that doing so too quickly could unleash “chaos.” Twenty Republican-led states sued in Texas arguing the health care law became unconstitutional when Congress repealed the “individual mandate,” or the tax penalty the ACA imposes on many people who fail to have what the government classifies as minimum qualifying coverage.

The Affordable Care Act is constitutional even without the tax penalty, Frosh argued in his lawsuit. Overturning the law “would throw millions off health insurance rolls by reversing Medicaid expansion, ending tax credits that help people,” and empower insurers to once again deny coverage based on pre-existing conditions, Frosh said in a statement announcing the filing.

Frosh sued U.S. Attorney General Jeff Sessions, the U.S. Department of Justice, and the U.S. Department of Health and Human Services (HHS).

Texas and the other states claim that when Congress repealed the tax penalty last year, it eliminated the U.S. Supreme Court’s rationale for finding the ACA constitutional in 2012.

While California, 14 other states and the District of Columbia won permission to intervene in defense of the ACA in Fort Worth, the Trump administration has sided, in part, with the states seeking to dismantle it, a factor acknowledged by Frosh in his statement.

The Trump administration has argued that invalidating the ACA individual mandate should kill the ACA provisions related to the underwriting and pricing of health coverage. But the administration has argued that the court should separate other ACA provisions from the underwriting and pricing provisions, and leave the other provisions intact, even if the court throws out the individual mandate.

The case is State of Maryland v. United States, U.S. District Court, District of Maryland (Greenbelt).

— Read States Continue ACA ‘Civil War’ in the Courts: NAIC Meeting Speakeron ThinkAdvisor.

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