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December 20, 2017

Trump seeks to end lawsuit over controversial ACA insurance payments

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    The Trump administration, House GOP lawmakers, and several state attorneys general on Friday filed a document in federal court that seeks to settle a lawsuit that challenges the executive branch's power to pay the Affordable Care Act's cost-sharing reductions (CSR) to insurers.

    Here's your cheat sheet for understanding health care's legal landscape

    Case details

    The lawsuit, which the House authorized in July 2014, contends that Congress never approved the Department of Treasury's CSR payments to insurers. U.S. District Judge Rosemary Collyer in May 2016 ruled that Congress had never appropriated funds for the payments, and that as a result, former President Barack Obama's administration did not have the authority to make the payments.

    The Obama administration last year appealed the ruling to the District of Columbia U.S. Circuit Court of Appeals, where it currently is on hold as House Republicans and the Department of Justice (DOJ) determine how they plan to proceed with the case under the Trump administration. The Trump administration in October announced that it would stop making the CSR payments after determining that it no longer could do so without an appropriation from Congress.

    Parties seek settlement

    In their court filing, the Trump administration, House Republicans, and state attorneys general involved in the case argued that the lawsuit is no longer relevant because the administration has halted the CSR payments. As such, the parties asked the court to essentially reverse Collyer's ruling that the executive branch is making the payments unconstitutionally, The Hill reports.

    The filing also states that the Trump administration does not accept the court's ruling that the House is legally able to sue the executive branch—a ruling that could have set a precedent for future cases, The Hill reports.

    According to The Hill, the settlement would have no immediate effect since the Trump administration is not currently making the CSR payments. However, Tim Jost, an emeritus professor at Washington and Lee University, said the move would make it possible for the executive branch to resume making the CSR payments in the future, because the court order blocking the payments would be dropped.

    The filing states that the settlement "should not in any way control the resolution of the same or similar issues should they arise in other litigation."

    A spokesperson for House Speaker Paul Ryan (R-Wis.) said, "We are gratified that as a follow-up to the executive branch's acknowledgement that making Obamacare payments to insurers without a congressional appropriation was unlawful, the parties have now agreed to resolve this lawsuit."

    Separate lawsuit continues

    According to Politico's "Pulse," the settlement would not affect a separate lawsuit filed by state attorneys general that seeks to force the Trump administration to continue making the payments.

    Sarah Lovenheim, an assistant to California Attorney General Xavier Becerra (D), said the settlement would "clea[r] the dust," allowing the states "to argue the underlying merits of the case for the legality of the payments" (Diamond, "Pulse," Politico, 12/18; Sullivan, The Hill, 12/15; Baker, "Vitals," Axios, 12/18; Nather, Axios, 12/15; Edney/Harris, Bloomberg, 12/15).

    Here's your cheat sheet for understanding health care's legal landscape


    With MACRA, HIPAA, the ACA, and countless others, the health care landscape has become an alphabet soup of legislation. To help you keep up, we've created a series of cheat sheets for some of the most important—and complicated—legal landmarks.

    Check them out now for everything you need to know about the Affordable Care Act, antitrust laws, fraud and abuse prevention measures, HIPAA, MACRA, and the two-midnight rule.

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