Donald Trump and Jeff Sessions
Donald Trump and Jeff Sessions (Nicholas Kamm / AFP/Getty Images)

Last week, a federal court in Texas heard oral arguments in yet another lawsuit attacking the Affordable Care Act.

The difference this time is that the Trump administration refused to defend the law — choosing instead to jeopardize the health care and financial well-being of tens of millions of Americans with pre-existing health conditions.


Back in 2010, before we passed the Affordable Care Act, one of the most devastating experiences for Americans with pre-existing conditions was being denied coverage by insurance companies or having to pay exorbitantly higher premiums just because they had gotten sick.

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A GOP proposal would require insurers to accept patients with preexisting conditions — but not to pay for their treatment.

This discrimination was allowed under federal law, and it was a leading cause of bankruptcies as families often lost their homes and their entire savings.

We ended this legalized discrimination by establishing a set of new statutory protections for people with pre-existing conditions. In addition to requiring that all Americans maintain health insurance coverage, federal law now bars insurance companies from:

  • refusing to cover people based on their pre-existing conditions — a protection known as “guaranteed issue”;
  • charging higher premiums for people with pre-existing conditions or people who happen to be women — a protection known as “community rating”;
  • and selling policies that exclude coverage for certain pre-existing conditions — a protection known as the “coverage exclusion prohibition.”

Yet, these critical protections are now in grave jeopardy.

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Millions of people covered under the Affordable Care Act will see only modest premium increases next year.

In 2012, the Supreme Court issued its landmark decision upholding the constitutionality of the health law’s requirement that individuals maintain health insurance coverage.

But when Donald Trump became president, his administration and Republicans in Congress sought to undermine the health care law by reducing to zero the penalty for not maintaining health insurance. They did this through the tax bill that was passed last year.

In June, Attorney General Jeff Sessions sent a letter informing House Speaker Paul Ryan that, because of this change, the Trump administration would no longer defend these essential statutory protections for people with pre-existing conditions in court. He explained that he was acting “with the approval of the President of the United States.”

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Americans with pre-existing conditions need to tell their representatives not to sacrifice their coverage to "solve" the problem of high premiums.

This decision was so indefensible that three of the four career attorneys representing the government withdrew from the case rather than sign their names to the brief. One attorney even resigned in the wake of the decision.

Protecting people with pre-existing conditions enjoys broad, bipartisan support. According to a recent Kaiser Family Foundation poll, nearly three-quarters of the American people believe it is “very important” to retain these protections in the law.

Yet, neither the president nor the attorney general offered any alternative protections for individuals with pre-existing conditions.

Their actions put at risk tens of millions of people with pre-existing conditions like cancer, diabetes and asthma, and these people live in red states, blue states and purple states.

For example, data analyzed by my staff on the Oversight Committee indicates that:

In my district in Baltimore, as many as 30,000 people who purchase insurance through the individual market could lose federal protections because of their pre-existing conditions.

In Rep. Carlos Curbelo’s district in Florida, as many as 49,000 people could face coverage exclusions or higher premiums because of their pre-existing health conditions, and 23,000 of these have pre-existing conditions severe enough that insurers may deny them coverage altogether.


In Rep. Pete Sessions’ district in Texas, as many as 29,000 women could be charged more just because of their gender.

And in Rep. Andy Barr’s district in Kentucky, as many as 11,000 older Americans could face higher premiums simply because of their age.

Trump isn't keeping his promises. He's scamming his base.

Trump's actions are just an outward veneer that gives the appearance of respecting people, but all the time manipulating laws to favor the wealthiest Americans.

These numbers do not capture the millions of Americans who obtain insurance through their employers, which may return to plans that exclude certain pre-existing health conditions.

President Trump and his administration are trying to take America back to a time when insurance companies were allowed to discriminate freely against people just for getting sick, being a woman or getting older. If their actions are allowed to stand, the nation may revert back to the era of legalized insurance company discrimination against people with pre-existing conditions.

Rep. Elijah Cummings (Twitter: @RepCummings) is the top Democrat on the Committee on Oversight and Government Reform in the U.S. House of Representatives.