Give Me Your Tired, Your Poor, Your Huddled Masses Yearning for Junk Health Plans

Give Me Your Tired, Your Poor, Your Huddled Masses Yearning for Junk Health Plans

On October 4, 2019 the President issued a Proclamation, barring the entry of immigrants to the United States unless they demonstrate that they have “approved” health insurance, or enough money to pay for their foreseeable health care costs.

The Proclamation includes short-term, or “junk” plans in the “approved” list, even though the ACA’s most important reforms don’t apply to them. They don’t cover individuals with pre-existing conditions or include important benefits like pregnancy services, prescription drugs, and mental health care. At the same time, the “approved” list is missing two important options that do provide comprehensive coverage: subsidized Marketplace plans and Medicaid.

The Proclamation is a twofer, furthering two of this Administration’s callous goals at once: reducing lawful immigration and attacking the Affordable Care Act and Medicaid program.

Fortunately a federal judge in Portland, Oregon, issued an injunction blocking implementation of the policy, finding that the proclamation violated existing immigration law. The administration promptly appealed this decision to the Ninth Circuit.

The National Health Law Program recently filed an amicus (or “friend of the court”) brief in the Ninth Circuit case, Doe v. Trump, opposing the Proclamation. We were joined on the brief by the American Public Health Association and 48 other health and immigration organizations from across the country, including the Association of Asian Pacific Community Health Organizations, East Bay Refugee and Immigrant Forum, Health Law Advocates, North Carolina Justice Center, Treatment Action Group, and Whitman-Walker Institute.

Our brief explains that Congress wanted newly arrived immigrants to have comprehensive coverage, and made it available to them through the ACA’s Marketplace and Medicaid. The Proclamation ignores Congress’s wishes and instead directs immigrants towards the short-term, junk plans that the President prefers.

We also highlight that the Proclamation relies on consular officers at the State Department to make complicated judgments about different kinds of health insurance and how much medical treatment is likely to cost. But consular officers are not health care experts. And we emphasize that the Supreme Court has previously rejected the idea that “Congress would have delegated,” important health care policy to an agency “which has no expertise in crafting health insurance policy of this sort.” King v. Burwell, 135 S. Ct. 2480, 2489 (2015).

The Government’s reply brief is due February 20, 2020. Once the case is fully briefed, the Ninth Circuit will set a date for oral argument.

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