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If the Supreme Court strikes down the Affordable Care Act, Trump’s health care order is not enough to replace it

Courtesy of Simon F. Haeder, Pennsylvania State University

The battle over the replacement of Justice Ruth Bader Ginsburg has refocused American attention on the future of the Affordable Care Act. The Supreme Court is scheduled to hear oral arguments Nov. 10 in a case seeking to overturn the law that brought insurance coverage to millions of Americans.

Meanwhile, Trump recently released his “America-First Healthcare Plan.” In it, the president claims significant achievements. He also outlines broad principles of his vision for the future of health care in America.

Over the past three years, the Trump administration has taken a number of steps to dismantle pieces of the ACA. And his recently introduced executive order lacks a number of key details and the legal grounds for enacting much of the proposal.

The two factors leave me – a health policy and politics scholar who has closely followed the Affordable Care Act – skeptical about the emergence of a meaningful replacement to the ACA that would expand insurance access should the Supreme Court invalidate the Obama administration’s signature achievement.

Trump’s moves on health care

President Trump campaigned and entered office with the pledge to “repeal and replace” the ACA. In his own words, there would be a “really great HealthCare Plan with far lower premiums (costs) & deductibles” right after the election.

Since 2016, Congress has made little headway besides eliminating the ACA’s penalty for not carrying insurance. This is the basis for the current lawsuit to be heard before the Supreme Court in November. The argument is that because Congress did away with the penalty, the individual mandate can no longer be constitutionally justified as a tax. As a result, the entire law should fall.

While Republicans have been unable to repeal the law, the Trump administration has taken a number of executive actions to limit its reach. In combination, these efforts have contributed to bringing the uninsured rate to 14% by 2019 from a low of 11% in 2016. This leaves millions of Americans without coverage and exposed to medical bills should they fall ill.

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With few details in Trump’s executive order on health care, the plan lays out goals for improved care and lower prices but offers no legal basis for implementing reforms. Brian Blanco via Getty Images

One of the major targets of the Trump administration has been reducing enrollment through the ACA’s marketplaces. Here, the administration shortened the periods in which people are allowed to purchase insurance and drastically reduced funding for individuals who help consumers enroll in coverage as well as advertising. It also withheld subsidies to support low-income individuals with out-of-pocket costs, which also caused problems to insurers offering plans to those people.

The administration has also worked to expand alternative insurance plans like so-called short-term, limited-duration health plans and association health plans. While these plans have lower premiums, they do not carry the consumer protections of the ACA like preexisting condition coverage. They also do not pay for prescription drugs

If the Supreme Court strikes down the Affordable Care Act, Trump’s health care order is not enough to replace it

<span class="caption">The Supreme Court will face another challenge to the Affordable Care Act that is more likely to succeed with the death of Justice Ruth Bader Ginsburg.</span> <span class="attribution"><a class="link rapid-noclick-resp" href="https://newsroom.ap.org/detail/SupremeCourtHealthOverhaulLawsuit/16788a32df5e42e6b50c77aeea97f7d5/photo?Query=affordable%20care%20act&mediaType=photo&sortBy=arrivaldatetime:desc&dateRange=Anytime&totalCount=3323&currentItemNo=31" rel="nofollow noopener" target="_blank" data-ylk="slk:AP Photo/Susan Walsh">AP Photo/Susan Walsh</a></span>
The Supreme Court will face another challenge to the Affordable Care Act that is more likely to succeed with the death of Justice Ruth Bader Ginsburg. AP Photo/Susan Walsh

The battle over the replacement of Justice Ruth Bader Ginsburg has refocused American attention on the future of the Affordable Care Act. The Supreme Court is scheduled to hear oral arguments Nov. 10 in a case seeking to overturn the law that brought insurance coverage to millions of Americans.

Meanwhile, Trump recently released his “America-First Healthcare Plan.” In it, the president claims significant achievements. He also outlines broad principles of his vision for the future of health care in America.

Over the past three years, the Trump administration has taken a number of steps to dismantle pieces of the ACA. And his recently introduced executive order lacks a number of key details and the legal grounds for enacting much of the proposal.

The two factors leave me – a health policy and politics scholar who has closely followed the Affordable Care Act – skeptical about the emergence of a meaningful replacement to the ACA that would expand insurance access should the Supreme Court invalidate the Obama administration’s signature achievement.

Trump’s moves on health care

President Trump campaigned and entered office with the pledge to “repeal and replace” the ACA. In his own words, there would be a “really great HealthCare Plan with far lower premiums (costs) & deductibles” right after the election.

Since 2016, Congress has made little headway besides eliminating the ACA’s penalty for not carrying insurance. This is the basis for the current lawsuit to be heard before the Supreme Court in November. The argument is that because Congress did away with the penalty, the individual mandate can no longer be constitutionally justified as a tax. As a result, the entire law should fall.

While Republicans have been unable to repeal the law, the Trump administration has taken a number of executive actions to limit its reach. In combination, these efforts have contributed to bringing the uninsured rate to 14% by 2019 from a low of 11% in 2016. This leaves millions of Americans without coverage and exposed to medical bills should they fall ill.

Trump health care executive order event
Trump health care executive order event

One of the major targets of the Trump administration has been reducing enrollment through the ACA’s marketplaces. Here, the administration shortened the periods in which people are allowed to purchase insurance and drastically reduced funding for individuals who help consumers enroll in coverage as well as advertising. It also withheld subsidies to support low-income individuals with out-of-pocket costs, which also caused problems to insurers offering plans to those people.

The administration has also worked to expand alternative insurance plans like so-called short-term, limited-duration health plans and association health plans. While these plans have lower premiums, they do not carry the consumer protections of the ACA like preexisting condition coverage. They also do not pay for prescription drugs or hospital stays. And unlike

The Senate must act to reauthorize cell transplantation program

Earlier this week, the House passed the TRANSPLANT Act, a bill Rep. Doris MatsuiDoris Okada MatsuiDemocratic lawmaker calls telehealth expansion the ‘silver lining’ of pandemic The Hill’s 12:30 Report: Delegates stage state-centric videos for the roll call Overnight Health Care: Obama leans into Trump criticism on coronavirus | CDC gives 3-month window for COVID-19 immunity MORE (D-Calif.) and I sponsored. It reauthorizes the C.W. Bill Young Cell Transplantation Program and the National Cord Blood Inventory, which will help tens of thousands of Americans of all ages who suffer with diseases like blood cancer, sickle cell anemia, inherited metabolic or immune system disorders and 70 otherwise fatal blood disorders. Every three minutes someone is diagnosed with a blood cancer throughout the nation. This is an especially important issue for seniors, as older Americans are the fastest growing age group of patients needing marrow transplants.

The mission of the national registry is to match patients and donors and to ensure the timely transportation of lifesaving cellular products throughout the United States and around the world. Over the past 30 years, more than 100,000 lifesaving and life-extending transplants have been facilitated through the national registry. Today, more than 22 million volunteers in the national registry are willing to answer the call to save a life. In partnership with other registries around the world, the program has access to more than 35 million donors. The National Marrow Donor Program(NMDP)/Be The Match registry is doing incredible work despite unprecedented challenges. While facing travel restrictions and other pandemic-related logistical dilemmas, this partnership has delivered a second chance at life to more patients than ever before. Surprisingly, the program completed more transplants in June of 2020 than in any single month in the program’s history and has conducted more than 3,000 transplants over the first six months of the public health emergency. This was only made possible by having the status of a federally-authorized program that is recognized by other federal, state and local agencies and foreign governments. Additionally, a CDC waiver allowed international bone marrow couriers to deliver cellular products from abroad to waiting U.S. patients, despite the European pandemic travel restriction, ensuring that more than 350 awaiting U.S. patients got their second chance at life.

Since its inception, the CW Bill Young Cell Transplantation Program has always enjoyed broad bipartisan support in both chambers of Congress because the donations made through this program literally save lives. The program has been reauthorized by Congress every five years, and is currently set to expire unless urgent action is taken. It is absolutely imperative that the House and Senate act swiftly and in unison to ensure that this critical life-saving work continues. Should the program’s authorization lapse at the end of September, there is concern that the program may not be able to operate as efficiently during the continuing public health emergency. My colleagues and I in the House recognize that this federal program provides critical support in the advancement of research for better treatments and the

Clean Air & Public Health Experts and Policymakers Celebrate 50 Years of the Clean Air Act at Virtual Symposium

‘Clean Air for All’ online symposium highlights progress made and remaining obstacles to ensure clean air for all Americans

WASHINGTON, Sept. 29, 2020 /PRNewswire/ — Fifty years after the passage of the Clean Air Act – the landmark public health law that has saved millions of American lives – policymakers, air quality experts, physicians and public health experts celebrated the anniversary and shared their insights into new and remaining threats to air quality during a virtual symposium.

American Lung Association logo (PRNewsfoto/American Lung Association)
American Lung Association logo (PRNewsfoto/American Lung Association)

“Clean Air for All: 50 Years of the Clean Air Act” was hosted by the American Lung Association and American University’s Center for Environmental Policy and Center for Environmental Filmmaking. The half-day event included several panel discussions featuring Clean Air Act author Tom Jorling; former EPA administrators Bill Reilly, Carol Browner and Gina McCarthy (who served both Democratic and Republican administrations); prominent environmental justice leaders; public health and climate experts, and more.

Recordings of each panel discussion will be posted here when available.

“It was an honor to participate in today’s event to celebrate the Clean Air Act and its legacy,” said Former EPA Administrator Bill Reilly. “As a result of the Clean Air Act, we have seen hundreds of thousands of lives saved every single year. We must continue to protect the Clean Air Act, and set our sights on the public health threat of climate change. This will be the next challenge for our nation, and we already see the impact of climate change in our air quality – from wildfire smoke to increased ozone pollution from rising temperatures. It’s critical that we take action to save lives.”

“For 50 years, the Clean Air Act has driven dramatic improvements in air quality and real health benefits for American families,” said American Lung Association President and CEO Harold Wimmer, who provided opening remarks at the virtual event. “Today’s symposium made clear that this lifesaving health law should not be taken for granted. Leading experts called attention to the fact that nearly half of Americans – including many communities of color – are breathing unhealthy air, and still waiting for the clean air promised by this law. Our work isn’t done until all Americans are breathing clean, healthy air.”

In recognition of 50 years of the Clean Air Act, the American Lung Association is celebrating improvements in air quality and championing a future of clean air for all. Through its new Stand Up For Clean Air initiative, the Lung Association is asking everyone to pledge to take action, because everyone has a role to play in addressing climate change and protecting lung health.

“As we celebrate this public health progress, we reaffirm our commitment to the Clean Air Act and to fulfilling its promise of healthy air for all communities,” Wimmer said. “In order to protect air quality, we must address climate change. Climate change is making it even harder to clean up air pollution – warmer temperatures and