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The Trump administration's latest effort to eliminate the Affordable Care Act's protections for pre-existing conditions is opening a rift among Republicans, and even within the executive branch.
Between the lines: Congressional Republicans are beginning to realize that the Trump administration has boxed them into a new round of questions about whether the party wants to guarantee coverage for pre-existing conditions.
Not messing around: "The Justice Department argument in the Texas case is as far-fetched as any I’ve ever heard. Congress specifically repealed the individual mandate penalty, but I didn’t hear a single senator say that they also thought they were repealing protections for people with pre-existing conditions," Sen. Lamar Alexander said in a statement.
Azar punts: HHS Secretary Alex Azar tried to duck the issue yesterday as he testified before the Senate HELP Committee, which Alexander chairs.
Reality check: The Justice Department did have to take a "constitutional and legal position" on the legality of the ACA's individual mandate. But its position on pre-existing conditions is very much a policy decision, and was entirely discretionary.
DOJ lawyer quits: Three DOJ lawyers removed themselves from this case after the department came out against the mandate. But one of them, Joel McElvain, who had worked at the department for 20 years, went further: He quit DOJ altogether after stepping down from this case, the Washington Post reports.
Be smart: This is just the beginning.
This latest lawsuit — and DOJ's decision to drag the ACA's most popular provisions into it — all stems from the way congressional Republicans chose to "repeal" the ACA's individual mandate.
Why they did it that way: It's because they passed the measure through special budget rules known as reconciliation, which only requires 51 votes but comes with unique restrictions about what can and can't be changed.
"I did not contemplate what some creative lawyer might come up with in terms of another idea to sue," Senate Majority Whip John Cornyn told my colleague Caitlin Owens.
The court decision allowing AT&T’s takeover of Time Warner, with no conditions, is good news for pending health care mergers, Axios' Bob Herman reports.
Yes, but: There’s still a chance antitrust officials could block these health care deals on the grounds the merged companies might have incentives to exclude rivals from their health insurance and pharmacy benefit options.
President Trump speaking while HHS Secretary Alex Azar looks on. Photo: The Asahi Shimbun via Getty Images
Two weeks ago, President Trump said drugmakers would be announcing “voluntary massive drops in prices” in two weeks. They haven’t happened. And Azar did not offer firm commitments to such price decreases in his testimony yesterday, per the Wall Street Journal.
What to watch: There’s been some talk about a voluntary reduction in insulin prices (prices, incidentally, that Azar helped raise), but the longer we go without any new or concrete action, the easier it’ll be for Democrats to argue that Trump’s drug pricing plan simply wasn’t strong enough.
The American Medical Association has formally — and overwhelmingly — endorsed a slate of gun control measures, calling gun violence a public health crisis. According to AP, the policies the AMA endorsed at its annual policy meeting yesterday include:
Why it matters: As the article notes, the AMA isn’t as powerful as it once was. But in the uphill climb to frame gun violence as a public health issue, having the AMA on board certainly can’t hurt.
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