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Capitol Correspondence - 11.12.19

Big Picture: Courts Pose Challenges to Key Trump Administration Health Policies

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This article by Politico Pulse is an informative review of the court status of health initiatives prioritized by the Trump Administration. ANCOR has followed all the issues listed below because of their potential effect on people with disabilities or the workforce that supports individuals with disabilities. As an update on this content, today at the National Association of Medicaid Directors (NAMD) annual conference, ANCOR staff heard Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma criticize efforts to “weaponize the legal system against state innovation”.  

As reported by Politico Pulse: “The president’s sweeping efforts to change the U.S. health system suffered another blow on Wednesday, with a New York judge throwing out HHS’ rule to expand conscience protections for health workers on grounds that it violated the Administrative Procedures Act and would create unnecessary harms.


WEDNESDAY’s REJECTION OF THE CONSCIENCE RULE is just the latest in a series of lower court defeats for the Trump administration’s health agenda.

— Medicaid work requirements have been halted in three states after a federal judge ruled against the policy. In the wake of the decisions, Indiana and Arizona voluntarily halted the rollout of their own work rules; a federal appeals court is now hearing the case. [See ANCOR’s letter of concern on Medicaid work requirements here.]

— Health care-linked immigration actions also are on hold. Trump’s recent order that limited visas to immigrants who aren’t ‘health burdens’ was temporarily paused this weekend, following an earlier order to limit the implementation of the president’s ‘public charge’ rule. [ANCOR note: roughly a quarter of the workforce that supports people with disabilities is comprised of immigrants, reflecting shortages of U.S.-born workers.]

— Association health plans remain on hold after a district court judge froze the Obamacare alternative back in March, although supporters believe the administration will win on appeal. [ANCOR covered this issue because it had potential to apply to state associations for disability supports.]

“WE’RE DOING HEALTH POLICY BY LITIGATION,” lawyer Katie Keith told PULSE. Keith pointed to the years-long fight over Obamacare’s birth control regulations as an example of unsettled policy. “Folks aren’t going to be satisfied until they hear from the Supreme Court once and for all,” she said.

BUT THE BIGGEST ITEM — THE LEGAL FATE OF OBAMACARE— REMAINS TBDwith the 5th Circuit yet to issue a decision on whether the Affordable Care Act should be struck down, as a lower court ruled last year.

The lawsuit was brought by GOP-led states and backed by the Trump administration; Democrat-led states have fought to preserve the ACA. It’s a near-guarantee that the ruling will be appealed to the Supreme Court.

AND THE ENDGAME: TRUMP IS MAKING THE COURTS MORE CONSERVATIVE — The president has rapidly filled out the federal bench, a point that he trumpeted in remarks on Wednesday.”