How Florida and the Trump administration are tampering with your health care

A Tampa Bay Times Editorial

The Trump administration just can't stop sabotaging Americans' access to health care. Instead of giving up after it failed to persuade Congress to repeal the Affordable Care Act, it continues to quietly undermine the law in ways that would reduce access and raise rates. It's a devious, coordinated effort to try to force the law to fail without any clue about how to protect millions of Americans who would be hurt.

In a stark reversal of President Donald Trump's previous position, the Justice Department now claims it can't even defend the ban on insurers denying coverage to people with pre-existing conditions. The abrupt abandonment of one of the key provisions of the Affordable Care Act that has overwhelming public support comes in response to a little-noticed federal lawsuit filed in February by the attorneys general of 20 states -- including Florida Attorney General Pam Bondi. The lawsuit argues that since Congress eliminated the financial penalty for failing to buy health insurance, the individual mandate that requires everyone to have coverage is unconstitutional and so the entire law should be overturned. Now the Justice Department won't defend the Affordable Care Act against this lawsuit and says consumer protections such as those involving pre-existing conditions can no longer be defended.

Tell that to 7.8 million Floridians and more than 50 million Americans who have pre-existing medical conditions ranging from arthritis to high blood pressure to pregnancy. Do we really want to go back to the days before the Affordable Care Act, when insurers could deny coverage to people with pre-existing conditions or only offer coverage that excluded the very health issues giving them the most trouble?

Of course, the federal lawsuit has a long way to go. Some legal experts doubt the states have much chance of winning since the U.S. Supreme Court upheld the guts of the Affordable Care Act in 2012. But this is only the latest effort by the Trump administration to undermine the law so they can further decry its shortcomings. Signing off on the repeal of the tax penalties for failing to have coverage. Refusing to pay billions owed to insurers whose losses were supposed to be covered during the first few years of the law. Skimping on advertising and sign-up efforts for 2018 coverage on the federal marketplace. No wonder premiums have been going up.

For consumers, it only gets worse. The Trump administration has proposed expanding short-term insurance plans into long-term coverage. Never mind these so-called "junk plans'' don't have to comply with the Affordable Care Act's consumer protections. That means they can charge higher premiums to women than to men. And they can exclude benefits such as coverage for mental health, prescription drugs or pregnancy. And they can put financial limits on annual or lifetime benefits. These plans may sound like good deals for healthy folks trying to save money, but they don't come close to comprehensive health coverage.

The proposed rules to expand short-term plans are predictably unsettling the market, because healthy people will be siphoned away from coverage that meets the requirements of the Affordable Care Act. That will drive those premiums up for everyone else, whether they buy individual coverage on the federal marketplace or elsewhere. The liberal Center for American Progress estimates the combination of the repeal of the individual mandate and the expansion of short-term plans could raise average premiums in Florida next year by $1,011, about the expected national average.

All of this financial and emotional pain is unnecessary for Floridians who need access to affordable health coverage and certainty their pre-existing conditions will continue to be covered. The state should not be party to a lawsuit still trying to overturn the Affordable Care Act. The Trump administration should not be undercutting the law at every turn. And voters should make clear in November they won't put up with it and elect leaders in Washington and Tallahassee who are more interested in expanding health coverage than gutting it.