Several of Michigan’s top Democrats offered a full-throated defense of the Affordable Care Act (ACA) Tuesday, as a federal appeals court in Louisiana considers its constitutionality once again.
The Fifth Circuit U.S. Court of Appeals began hearing oral arguments Tuesday in Texas v. Azar, in which 20 attorneys general argue that the ACA is unconstitutional in full due to the removal of its individual mandate as part of the 2017 federal tax reform bill. The Trump administration, which previously backed Republican legislative efforts to fully “repeal and replace” the law, has endorsed the lawsuit, filing a brief in its support in May.
Michigan Attorney General Dana Nessel, who earlier this year intervened on behalf of the ACA along with another group of attorneys general, released a statement Tuesday calling the new suit the “clearest indication of [Trump’s] intention to strip coverage from millions of Americans and decimate protections for pre-existing conditions.” She argued that “720,000 Michiganders could lose their coverage — leading to a 115% increase in our uninsured rate.”
The figure Nessel cites is the same as that predicted in a 2018 report from the Urban Institute. ACA insurance market analyst Charles Gaba wrote today that by his own calculations the number could be even higher, with more than 800,000 residents losing coverage.
“And that’s just scratching the surface,” Gaba told the Advance, pointing out that “if you repeal the entire law, there’s a mess of other stuff it includes that makes [the impact of repeal] not easy to boil down.”
Gaba cited the bill’s funding for community health centers, its efforts to cover Medicare Part D “donut hole,” and its various programs that fund medical innovation efforts.
He also pointed out that the ACA’s repeal would eradicate the Medicaid expansion it authorized, making the recent argument over Michigan’s planned work requirements moot. A 2017 study by Bridge showed that full repeal of the ACA could affect roughly one in 10 Michigan residents in some way.
In a call with reporters Tuesday, U.S. Sen. Gary Peters (D-Bloomfield Twp.) acknowledged that the law more commonly referred to as “Obamacare” has room for improvement, but said that its repeal would be a mistake.
“We have to do more work to improve health care coverage and lower costs,” Peters said. “But I do not believe that we achieve that if rates are increased dramatically, coverage is worse, or care is jeopardized altogether.”
The Fifth Circuit ultimately will decide whether the legal challenge to Obamacare, which was previously upheld by a district court judge in Texas, will make it to the U.S. Supreme Court. Peters acknowledged that if that happens, the court’s conservative majority could be a major threat to the law.
“You have to take this threat to the ACA seriously,” Peters said. “We don’t know how the court is going to rule, and given the fact that President Trump is using the Justice Department to argue this case, that shows that they’re putting the full weight of the administration in trying to repeal it … although [the Supreme Court] has ruled in the past that the Affordable Care Act is constitutional, that we now have new members, and it’s possible that could change.”
Several members of Michigan’s congressional delegation weighed in on the issue as well, including freshman Rep. Haley Stevens (D-Rochester), who’s been unequivocal in her support for the law while up for re-election in 2020 in a Republican-leaning district.
“I voted on Day One to throw the full legal weight of the House of Representatives against this disastrous lawsuit,” Stevens said in a statement, referring to a party-line vote early in this congressional session that authorized the House of Representatives’ intervention in the lawsuit.
“Tens of millions of Americans could lose their health coverage, including hundreds of thousands of Michiganders living with pre-existing conditions,” Stevens wrote. “Michiganders deserve better.”
U.S. Rep. Fred Upton (R-St. Joseph) was one of only eight Republican House members, and the only Michigan Republican, to vote in favor of an April resolution opposing the Trump administration backing the lawsuit.
His spokesperson declined to offer comment on the new court proceedings, but in a statement at the time, Upton said that if the lawsuit succeeded it would be “cruel and irresponsible,” akin to “pulling the safety net out from under our fellow Americans.”
Several Democratic state lawmakers slammed efforts to kill the ACA, including state Rep. Darrin Camilleri (D-Brownstown Twp.).
“This lawsuit by the Trump administration is a shameless attempt to rip health care away from hardworking Americans,” he said. “This administration is giving the green light to insurance companies to deny coverage and drive up costs while turning its back on people with pre-existing conditions, seniors, and the thousands more in our state whose health insurance is in jeopardy if this lawsuit is successful. Yet again, the Trump administration is making its allegiances plain, and they aren’t with Michiganders.”
And Gov. Gretchen Whitmer said she and Nessel are “committed to working every day to make sure Michigan families can get the care they need, and that starts by defending the Affordable Care Act and expanding coverage to people across the state.”
If the case reaches the U.S. Supreme Court it will be heard during its next term, which begins in October.