Medicare is unconstitutional for everyone

Trump takes health insurance "Obamacare" to court

Barack Obama had brought the Health Care Act into being, and his successor Donald Trump would like to abolish it at all costs. On the political path, he has so far not had any success with this project. Therefore, the US President is now using the legal process. The trial will be held on July 9 in the New Orleans federal appeals court.

If Trump wins, millions of people will soon be without health insurance. From the layman's point of view, the legal dispute over the “Affordable Care Act” (ACA) is difficult to understand. It goes back to a December decision by a federal judge in Texas. ACA was unconstitutional, found Judge Reed O'Connor in response to a lawsuit by Republican governors. Trump's tax reform of 2017 removed “Obamacare” the legal basis.

Democratic governors have appealed against O'Connor's "unfounded" verdict. Justice and politics are mixed up: O’Connor is considered to be extremely conservative. The New Orleans court with jurisdiction over appeals from Texas, too. Eleven of the 16 judges were appointed by Republican presidents, five by Trump.

Insurance groups determine the market

The health insurance system in the USA is a patchwork of holes in government policies for the very poor (Medicaid) and for all seniors (Medicare), private insurance and employer's insurance. Insurance groups determine the market. ACA is intended for people who are not insured at work, too young for Medicare, and not “poor enough” for Medicaid.

So-called "insurance exchanges" broker policies. The state prescribes minimum benefits and pays low-income people a portion of the premiums, often several hundred dollars a month. Access to Medicaid has been made easier. According to calculations by the “Commonwealth Fund”, a foundation for the improvement of the health system, since 2010 the proportion of uninsured people aged between 19 and 65 has fallen from 20 to 12 percent.

Also read: Abolition of "Obamacare" failed

Stopping “Obamacare” is a matter close to Trump's heart. Many of his Republicans reject the expansion of the welfare state for ideological reasons. Trump also complains that the premium costs are too high and that the law is a "disaster".

In fact, there is a lot going on in the US healthcare system. Many insurance companies only cover part of the treatment and drug costs. Often people travel to Canada to get medicines cheaply.

He felt "like a hostage" of the pharmaceutical industry and its insurance company, said an employee of the patient association "Minnesota Insulin for All", Quinn Nystrom. In the US, insulin costs about ten times as much as in Canada. Obamacare is also problematic for people from the middle class who are not insured through their employers and who earn too much for government subsidies for the premiums. The policies are also particularly expensive for people over 50.

"Greed and huge profits"

The ACA reforms are one of the very hot concerns in the primary campaign of the democratic presidential candidates. Senator Bernie Sanders wants comprehensive state insurance. “Medicare for All” is the name of the concept based on the existing insurance for senior citizens. Insurance companies would be displaced. He wants to act against "greed and huge profits," says Sanders.

Some contenders are more cautious. All Americans should have access to a Medicare-like program, said Candidate Pete Buttigieg, Mayor of South Bend, Indiana. However, private insurance should be retained. Former Vice President Joe Biden wants to develop Obamacare further. A new state insurance should exist alongside private offers. Despite their criticism, Republican politicians have not adopted a reform plan of their own - although they have a majority in Congress.

The political and legal turmoil has not yet ended: the loser in the New Orleans trial is likely to appeal. The final decision on the constitutionality of the law rests with the Supreme Court. The verdict would probably not come until 2020 - in the middle of the presidential election campaign.

Also read: Trump fights Obamacare with a crowbar

From RND / epd