Workers protections seen at risk in Trump Health Care shift

The Trump administration's latest move against "Obamacare" could jeopardize legal protections on pre-existing medical conditions for millions of people with employer coverage, particularly workers in small businesses, say law and insurance experts.

At issue is Attorney General Jeff Sessions' recent decision that the Justice Department will no longer defend key parts of the Obama-era Affordable Care Act in court. That includes the law's unpopular requirement to carry health insurance, but also widely supported provisions that protect people with pre-existing medical conditions and limit what insurers can charge older, sicker customers.

Two independent experts said Wednesday that the administration appears to be taking aim at provisions of the ACA that protect people in employer plans, not only the smaller pool of consumers who buy a policy directly from an insurer. The new Trump administration position was outlined last week in a legal brief filed by the Justice Department in a Texas case challenging the Obama health law.

Workers "could face the prospect of insurance that doesn't cover their pre-existing conditions when they enroll in a plan with a new employer," said Larry Levitt of the nonpartisan Kaiser Family Foundation.

University of Michigan law professor Nicholas Bagley said the administration does not appear to have thought through all the consequences of moving against one provision of a health law that has many complicated interlocking parts.

"The lack of care on the brief is jaw-dropping," said Bagley, who supports the Obama health law but considers himself a "free agent" critic of both sides. "There is no question that the Trump administration has to clarify what the scope of its injunction would be and grapple with the consequences of mowing down parts of the ACA.

"For someone with a pre-existing condition thinking about switching jobs, the answer to the question could make a life-changing difference," added Bagley.

Both Bagley and Levitt said their questions about the administration's intentions arose from language in the Justice Department brief that specifically singles out sections of the health law that apply to employer plans. The ACA strengthened previous protections already in federal law that limited the circumstances and length of time under which an employer could exclude coverage for a worker's pre-existing health problems.

The Trump administration had no immediate rebuttal to the issues raised by the two experts.

Instead, the Health and Human Services Department pointed to comments earlier in the week by Secretary Alex Azar, who told senators that the Justice Department brief was a legal and constitutional argument, not a policy statement.