It wasn't that long ago that people could lose their health insurance coverage or be denied the opportunity to purchase a new policy because of a pre-existing condition. The Affordable Care Act put an end to such often-devastating outcomes.
Now it's possible America could return to those bad old days. If that happens, the Indiana attorney general's office will be among the entities responsible.
Last year's efforts to “repeal and replace” Obamacare focused public attention on why the Affordable Care Act, flawed though it was, had been a step forward.
For the first time, polls showed support for the law inching above the 50-percent mark. But subsequent efforts to address those flaws have been stalled by presidential and Republican congressional moves to weaken the measure they were unable to kill outright.
The tax-cut bill signed by President Donald Trump in December eliminatedthe tax penalty for individuals who failto maintain at least minimum health coverage.
That requirement, called the individual mandate, was meant to keep premiums lower by ensuring that healthy people as well as sick people were covered. It has been Obamacare's least popular feature.
Now a legal end-run by a group of Republican state attorneys general that includes Indiana's Curtis Hill has endangered the law's most popular provision. The end of individual mandate penalties, the complaint argues, invalidates the individual mandate itself and thus makes the whole of the Affordable Care Act unconstitutional, including the prohibition against denial of coverage because of pre-existing conditions.
For the attorneys general, this would not exactly be a case of responding to overwhelming public demand. A poll last summer by the nonpartisan Kaiser Family Foundation showed 70 percent of Americans supporting the pre-existing-conditions protection.
But last week, the complaint received a legal turbocharge when the Justice Department announced it will not defend key portions of the Affordable Care Act, including the protection for insurance applicants with pre-existing conditions, when the matter is heard in federal court.
This is a departure from tradition – normally the department defends any law passed by Congress.
In a news release Monday, Hill praised the Justice Department'sdecision, calling the Affordable Care Act “federal overreach. Rather than legislating a one-size-fits-all mandate imposed nationwide, Congress should allow Indiana and all the other states to exercise freedom in the ways they deal with the issue of health care for their own citizens.”
“Exercising freedom” sounds pretty noble. But the chances of Indiana or other states enacting workable substitutes for the federal pre-existing condition rule are slim at best.
If Hill and his colleagues prevail, it could take America back to the days when people with cancer, diabetes, asthma or other long-term illnesses could once again find themselves unable to obtain health insurance, at least at a price they could afford to pay.
According to Kaiser, that could include at least 30 percent of our state's non-elderly adults – 1.175 million Hoosiers.