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Trump administration moves to dismiss Baltimore’s ACA lawsuit

The HealthCare.gov website is photographed in Washington, Wednesday, Oct. 31, 2018. Numbers released this week by the government show just a slight dip in people enrolled for Affordable Care Act coverage next year through HealthCare.gov. That’s the case even though the Republican-led Congress repealed fines for being uninsured effective Jan. 1. The drop _ from 8.8 million to 8.5 million _ was far less than experts forecast. (AP Photo/Pablo Martinez Monsivais)

The HealthCare.gov website is photographed in Washington, Wednesday, Oct. 31, 2018. (AP Photo/Pablo Martinez Monsivais)

The Trump administration filed a motion Monday seeking the dismissal of a lawsuit filed by a group of cities, including Baltimore, critical of the implementation of the Affordable Care Act.

Baltimore, Columbus, Cincinnati and Chicago filed suit in August alleging the Trump administration “intentionally sabotaged” the ACA by discouraging enrollment, raising prices and misappropriating funds allocated to support the law. The cities are joined by a Charlottesville couple.

The lawsuit names President Donald Trump, the U.S. Department of Health and Human Services and its secretary, Alex M. Azar II, and the Centers for Medicare and Medicaid Services and its administrator, Seema Verma.

But in a motion to dismiss filed Monday in U.S. District Court in Baltimore, the defendants argue the plaintiffs have no standing because the dispute is a political disagreement which is outside of the court’s jurisdiction, despite the plaintiffs’ “compilation of a laundry list of alleged grievances.”

The complaint alleges violations of the Administrative Procedure Act and the Take Care Clause, which requires the president to “take care that the laws be faithfully executed.” The defendants argue the clause does not provide a cause of action against the president and the court cannot enjoin the president in the performance of official duties.

The alleged injuries are also speculative and dependent on the actions of third parties outside of the federal government’s control, according to the motion.

Anne Harkavy, executive director of Democracy Forward, which joined Baltimore as co-counsel on the case, said Thursday the administration “ignores the many ways its own actions have driven up healthcare costs throughout the country, and fails to acknowledge that the ACA remains strong because citizens, cities, nonprofits and others are actively working to protect the law in the face of an administration intent on destroying it.”

The cities claim the administration’s actions will destabilize the health insurance marketplace, drive individuals out of ACA coverage and cause local governments to bear the cost of providing care through clinics and ambulance services. They argue defendants are trying to discourage enrollment and reduce choices for those seeking coverage.

However, the defendants point out that monthly premiums for individual market plans will generally decrease in 2019 and there will be more individual market insurers compared to 2018, which should increase competition and stabilize or decrease costs.

The market is “inherently variable” and there are factors for different states, markets and issuers which can impact costs.

“All those factors make it impossible to determine with any degree of certainty that any market will encounter an increase in premiums for ACA-compliant health insurance, and if premiums do increase, whether and to what extent they are attributable to the challenged rules and executive actions,” the motion claims.

The case is City of Columbus, et al., v. Donald J. Trump, et al., 1:18-cv-02364.


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