One of Donald Trump's Affordable Care Act sabotage attempts was to try to subvert it with a rule allowing small businesses and individuals to band together to create association health plans that didn't have to adhere to the law. No can do, said a federal judge on Thursday. That's Trump second major loss in the courts in his sabotage efforts in a week, after a judge blocked his Medicaid work requirement waivers in Kentucky and Arkansas.
In the association health plans case, Judge John Bates of the United States District Court for the District of Columbia said the move was "clearly an end-run around the A.C.A." and unlawful. The rule must be set aside, he wrote, because it "does violence" to the Employee Retirement Income Security Act of 1974. That law created the framework for employer-provided health insurance, and Bates says Trump's rule alters the statutory definition of "employer" to include "virtually any association of disparate employers connected by geographic proximity," and even self-employed individuals with no employees.
The final rule Labor Secretary Alexander Acosta came up with, Bates wrote, "creates absurd results under the Affordable Care Act. […] Because the final rule stretches the definitions of 'employer' beyond what the statute can bear, the final rule is unlawful" under the Administrative Procedure Act. That's the statute the Trump administration has regularly been ignoring in promulgating its questionable rules, including the one allowing states to impose work requirements on Medicaid recipients. The judge was not at all amused by Trump and Acosta's rule or the rationale behind it, calling the effort to somehow turn self-employed individuals into employers "a magic trick" and the Labor Department's defense a sleight of hand.
Ten states, led by New York, brought the association health plans suit. "We are pleased that the District Court saw past the Trump administration’s transparent effort to sabotage our health care system and gut these critical consumer protections in the service of its partisan agenda," Letitia James, the attorney general of New York State, said after the ruling.