California takes on Texas and Trump over billions of health care dollars

California Attorney General Xavier Becerra moved today to intervene in a Texas lawsuit aimed at undoing Obamacare. Becerra and 15 other attorneys general joined forces to file their motion to prevent “immediate and irreparable harm,” as Becerra put it, to California and other states.

At stake is an estimated $160 billion in federal dollars for California’s health care system, with a combined potential loss of about $500 billion for 15 states and the District of Columbia, according to Becerra. The Trump administration and the Republican-controlled Congress repeatedly have tried to unravel or eliminate Obamacare, with mixed results.

“The Affordable Care Act changed the world,” Becerra said. “We can’t and we won’t go back.”

He pointed out that roughly 5 million people were signed to insurance coverage in California through Obamacare, under the Covered California exchange and the state’s expansion of Medi-Cal ranks. Before Obamacare, he also noted, many health conditions weren’t covered even if patients had insurance, and some patients were denied care based on pre-existing conditions. But all of that changed under the Affordable Care Act.

If Obamacare is overturned, the federal dollars that go with it will evaporate. That includes subsidies for insurance bought through the Covered California exchange, and a large share of the cost for California’s Medi-Cal expansion.

The 16 Democratic attorneys general hope to be allowed to participate fully in the court debate, which affects states outside of Texas.

California Attorney General Xavier Becerra

California Attorney General Xavier Becerra

“Striking down the Affordable Care Act would cause immediate and irreparable harm to California and the nation,” Becerra said. “If this lawsuit goes forward, it will cause chaos. It’s our intent to protect families in California.”

Texas et al. v. United States et al. argues the Affordable Care Act is no longer valid because the recent tax overhaul by Congress eliminated the requirement that individuals have health insurance or pay a fine. Without that penalty, Obamacare no longer includes a tax imposed by Congress, and that spells the end of it, according to the lawsuit.

“Once the heart of the ACA—the individual mandate—is declared unconstitutional,” the Texas complaint says, “the remainder of the ACA must also fall.”

“The repeal of the Affordable Care Act would have devastating consequences for California and the nation,” said Gerald Kominski, director of the UCLA Center for Health Policy Research. “The (Texas) lawsuit seems frivolous, because Congress modifies existing law all the time, but that does not invalidate the original law being modified.”

Becerra noted that the ACA’s constitutionality already has been upheld by the U.S. Supreme Court.

The other attorneys general joining the motion to intervene are from Connecticut, Delaware, Hawaii, Illinois, Kentucky, Massachusetts, North Carolina, New Jersey, New York, Oregon, Rhode Island, Virginia, Vermont, Washington and the District of Columbia.

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