Indiana part of latest attempt by 20 states to scrap Obamacare

WASHINGTON — A top Indiana official is again trying to get rid of Obamacare.

Attorney General Curtis Hill has joined 19 other states in a coalition led by Texas and Wisconsin that is challenging the constitutionality of the 2010 Affordable Care Act.

The suit filed in federal court in Texas Monday argues that President Obama's signature health care law should be struck down now that Congress got rid of the tax penalties the ACA imposed on some people who do not purchase health insurance.

When the Supreme Court upheld the constitutionality of the ACA in 2012, the justices said the individual mandate — a key provision of the law — was allowed because the penalty for not having coverage could "reasonably be characterized as a tax," and Congress has the authority to impose taxes. 

The GOP tax bill President Trump signed into law in December eliminated the individual mandate's financial penalties starting in 2019. 

"Once that falls, then Obamacare falls," Wisconsin Attorney General Brad Schimel said at a news conference in Washington Tuesday. 

The attorneys general said they did not consult with the Trump administration in advance of filing the suit against the U.S. Department of Health and Human Services, but hope that the federal government will agree with their side.

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All of the attorneys general or governors who signed onto the challenge are Republican. Nine, including Indiana, represent states that took the federal money made available by the ACA to expand Medicaid eligibility. 

But Indiana's governors and attorneys general have also fought the ACA in court and in Congress.

Hill's predecessor, former Attorney General Greg Zoeller, joined one of the original challenges to the ACA filed soon after its passage. 

Zoeller also collaborated with more than three dozen Indiana school districts in unsuccessfully challenging the ACA's requirement that larger employers, including government entities, offer insurance to workers. That suit also unsuccessfully argued that Indiana residents should not be eligible for the ACA's federal subsidies for private insurance because the state opted out of running an insurance exchange for people not covered through a job or government program.

Hill said Tuesday it's the responsibility of the attorneys general to test whether the law is constitutional. 

"This will allow for Indiana to exercise its own freedom with regard to how it deals with the issue of health care for its own citizens," Hill said of the latest attempt.

Hill said he did not consult with Gov. Eric Holcomb before joining the challenge. 

Holcomb was unavailable for comment Tuesday, according to his spokeswoman.

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Holcomb last year backed at least one version of proposed GOP legislation to repeal and replace Obamacare. The bill — which failed to pass as did other versions — would have scaled back Medicaid funding and reduced subsidies for private insurance. 

The Indiana Hospital Association, which opposed legislative efforts to undo the law, declined to comment on the new legal challenge Indiana joined.

Susan Jo Thomas, executive director of Covering Kids & Families of Indiana, called Indiana's participation in the suit concerning. 

"State leadership has assured us, however, that they place the highest importance on health care coverage, just as when they first created the pre-ACA Healthy Indiana Plan," Thomas said of Indiana's alternative Medicaid program. 

The share of Indiana's non-elderly adults lacking insurance dropped from about 19 percent before major portions of the ACA went into effect to about 11 percent in 2016, according to the nonpartisan Kaiser Family Foundation.

The two main provisions of the law aimed at increasing insurance coverage are the ACA's expansion of Medicaid to those earning up to 138 percent of the federal poverty level, and private insurance subsidies for those earning up to four times the poverty level. 

The number of Hoosiers using the federal health exchange to purchase private insurance dropped this year by about 4.5 percent, to 166,711. 

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The drop came after a shorter enrollment period, cutbacks in federal funding for outreach, rising premiums, an exit by two of the four participating insurance companies and continued uncertainty about the future of the law.

A study released Monday by the left-leaning Urban Institute estimated average premiums for exchange plans could rise 20 percent in Indiana next year because of the elimination of the individual mandate's penalties, and because of the Trump administration's proposal to allow people to purchase short-term plans that could draw healthier people out of the exchanges.

Indiana Sen. Joe Donnelly, a Democrat facing re-election this year, blamed rising premiums on "continued efforts by the administration to undermine our health care system."

The latest Obamacare legal challenge was praised by FreedomWorks, a Washington advocacy group aligned with the Tea Party. 

"Thank goodness there are still Republican defenders of the Constitution somewhere in government," said former Virginia Attorney General Ken Cuccinelli who is now director of FreedomWorks Foundation's Regulatory Action Center.

But Frederick Isasi, executive director of the liberal advocacy group Families USA, said the states challenging the law should be working to improve it instead of "playing politics" and trying to dismantle existing funding and protections for their residents.

Contact Maureen Groppe at mgroppe@gannett.com. Follow her on Twitter: @mgroppe.