Trump officials broaden their attacks on health law and argue that courts should dismiss all this

WASHINGTON – The Trump administration expanded its attack on Monday against the Affordable Care Act, declaring to a federal court of appeal that she now felt that the entire law should be invalidated.

The administration had previously said that the protections provided by law for people with pre-existing disorders should be rescinded, but that the rest of the law, including the Medicaid extension, should survive.

If the Court of Appeal accepts the Trump administration's new arguments, millions of people risk losing health insurance, including those who are covered by the Medicaid extension and those who benefit from private coverage subsidized by the federal government.

"The Justice Department no longer calls for partial invalidation of the Affordable Care Act, but says the entire law should be rescinded," said Abbot R. Gluck, a law professor at Yale who followed the dispute closely. "Not just some of the insurance provisions, but all of its components, including the expansion of Medicaid and hundreds of other reforms. It is a real bomb that could have disastrous consequences for millions of people. "

It is also certain that the new position will spark a new political wave about the Affordable Care Act, ensuring that it will become even more prominent in the 2020 elections. Democrats have said that President Trump still wants to abolish the law. law and they can now invoke the filing of the Department of Justice as evidence to support this assertion.

The Justice Department unveiled its new position in a two-sentence letter to the United States Court of Appeals for the Fifth Circuit in New Orleans, and will set out its position in a later submission.

In the letter, the Justice Department said the court should uphold a December ruling by Judge Reed O'Connor of the Fort Worth Federal District Court.

O'Connor JA, in a general opinion, stated that the individual mandate for individuals to take out health insurance "can no longer be maintained as an exercise of the fiscal power of Congress" because Congress had removed the penalty tax for people without health insurance.

As a result, Justice O'Connor stated that "the individual mandate is unconstitutional" and that the remaining provisions of the Affordable Care Act are also invalid.

In his letter to the court of appeal, the Justice Ministry said on Monday that it "does not exhort to overturn part of the district court's judgment". In other words, he agrees with Justice O'Connor's decision.

Since it was signed by President Barack Obama nine years ago, the Affordable Care Act has been integrated into the country's health system. This has changed the way Medicare pays doctors, hospitals and other health care providers. This sparked a tidal wave of innovations in the delivery of health care. The health insurance industry has invented a new business model that offers coverage to anyone who wants it, regardless of the conditions.

The law also includes dozens of provisions that are less well known and unrelated to the individual mandate. It requires nutritional labeling and the number of calories on menu items in restaurant chains. Some employers must provide a "reasonable break time" and a private space where breastfeeding mothers can draw breast milk. It has improved prescription drug coverage for Medicare beneficiaries and created a new path for approving cheaper versions of biologic drugs made from living cells.

The lawyers said that the invalidation of the entire law would raise many legal and practical issues. They said that it was hard to imagine what the world would look like without the Affordable Care Act.

The new position of the Trump administration has been severely criticized by the insurance industry and consumer advocates.

The government's position "endangers the coverage of more than 100 million Americans," said Matt Eyles, president and chief executive officer of America's Health Insurance Plans.

Leslie Dach, president of Protect Our Care, a consumer advocacy group, said, "In November, voters overwhelmingly rejected President Trump's revocation and sabotage program. But he remains determined to accomplish in court what he and his Congressional allies would not be able to legislate: totally repeal the law, devastate American health care and leave millions of Americans at risk. "

The new position of the Trump administration seems to put Republicans in Congress in an uncomfortable position. They have repeatedly tried to repeal the health act. But over the past year, they have said over and over again that they want to protect people who already have an existing disease, and that these protections are among the most popular provisions in the law.

The lawsuit challenging the Affordable Care Act (Texas v. United States) was launched last year by a group of Republican governors and attorneys general. California officials and more than a dozen other states have stepped in to defend the law.

The Texas lawsuit "is as dangerous as it is inattentive," California Attorney General Xavier Becerra said Monday, filing a brief in which he urged the court of appeal to uphold the law.

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