H. Res. 271 

In the House of Representatives, U. S., 

April 3, 2019. 

Whereas on February 26, 2018, 18 State attorneys general 

and 2 Governors filed a lawsuit in the United States District Court for the Northern District of Texas, Texas v. 

United States, No. 4:18–cv–00167–O (N.D. Tex.) (in 

this preamble referred to as ‘‘Texas v. United States’’), 

arguing that the requirement of the Patient Protection 

and Affordable Care Act (Public Law 111–148; 124 Stat. 

119) (in this preamble referred to as the ‘‘ACA’’) to 

maintain minimum essential coverage is unconstitutional 

and, as a result, the court should invalidate the entire 

law; 

Whereas in a June 7, 2018, letter to Congress, then Attorney 

General Jefferson Sessions announced that the Department of Justice— 

(1) would not defend the constitutionality of the 

minimum essential coverage provision; and 

(2) would argue that provisions protecting individuals with pre-existing conditions (specifically the provisions commonly known as ‘‘community rating’’ and 

‘‘guaranteed issue’’) are inseverable from the minimum 

essential coverage provision and should be invalidated; 

Whereas in the June 7, 2018, letter to Congress, Attorney 

General Sessions also advised Congress that ‘‘the Depart-
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ment will continue to argue that Section 5000A(a) is severable from the remaining provisions of the ACA’’, indicating a difference from the plaintiffs’ position in Texas 

v. United States; 

Whereas on December 14, 2018, the United States District 

Court for the Northern District of Texas issued an order 

that declared the requirement to maintain minimum essential coverage unconstitutional and struck down the 

ACA in its entirety, including protections for individuals 

with pre-existing conditions; 

Whereas the decision of the United States District Court for 

the Northern District of Texas was stayed and is pending 

appeal before the United States Court of Appeals for the 

Fifth Circuit; 

Whereas on March 25, 2019, the Department of Justice, in 

a letter to the United States Court of Appeals for the 

Fifth Circuit, changed its position and announced that 

the entire ruling of the United States District Court for 

the Northern District of Texas should be upheld and the 

entire ACA should be declared unconstitutional; 

Whereas prior to 2014, individuals with pre-existing conditions were routinely denied health insurance coverage, 

subject to coverage exclusions, charged unaffordable premium rates, exposed to unaffordable out-of-pocket costs, 

and subject to lifetime and annual limits on health insurance coverage; 

Whereas as many as 133 million nonelderly people in the 

United States— 

(1) have a pre-existing condition and could have 

been denied coverage, only offered coverage at an exorbitant price had they needed individual market health in-
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surance prior to 2014, or had coverage for their pre-existing condition excluded prior to 2014; and 

(2) will lose protections for pre-existing conditions if 

the ruling of the United States District Court for the 

Northern District of Texas is upheld in Texas v. United 

States; 

Whereas contrary to President Trump’s public claims that he 

supports protections for people with pre-existing conditions, he has ordered his Department of Justice to actively pursue the destruction of these protections in Federal court; 

Whereas employer-provided health plans cannot place lifetime 

or annual limits on health coverage, and if the Trump 

Administration succeeds in its argument before the court, 

more than 100 million people in the United States who 

receive health insurance through their employer could 

once again face lifetime or annual coverage limits; 

Whereas if the Trump Administration succeeds in its argument before the court, insurers would be allowed to impose an unlimited ‘‘age tax’’ on the health insurance premiums of older Americans; 

Whereas prior to 2010, Medicare enrollees faced massive outof-pocket prescription drug costs once they reached a certain threshold known as the Medicare ‘‘donut hole’’, and 

since the donut hole began closing in 2010, millions of 

Medicare beneficiaries have saved billions of dollars on 

prescription drugs; 

Whereas at a time when 3 in 10 adults report not taking prescribed medicines because of the cost, if the Trump Administration succeeds in its argument before the court, 
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seniors enrolled in Medicare would face billions of dollars 

in new prescription drug costs; 

Whereas as of March 2019, 37 States, including the District 

of Columbia, have expanded or are in the process of expanding Medicaid to individuals with incomes up to 138 

percent of the Federal poverty level, providing health coverage to more than 12 million newly eligible people; 

Whereas if the Trump Administration succeeds in its argument before the court, the millions of individuals and 

families who receive coverage from Medicaid could lose 

eligibility and no longer have access to health care; 

Whereas as of March 2019, many people who buy individual 

health insurance are provided tax credits to reduce the 

cost of premiums and assistance to reduce out-of-pocket 

costs such as copays and deductibles, which has made individual health insurance coverage affordable for millions 

of people in the United States for the first time; 

Whereas if the Trump Administration succeeds in its argument before the court, the health insurance individual exchanges would be eliminated and millions of people in the 

United States who buy health insurance on the individual 

marketplaces could lose coverage and would see premium 

expenses for individual health insurance increase exorbitantly; 

Whereas if the Trump Administration succeeds in its argument before the court, people in the United States would 

lose numerous consumer protections in their coverage, including the requirements that— 

(1) plans offer preventive care without cost-sharing; 

(2) young adults have the option to remain on a parent’s insurance plan until age 26; and 
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(3) many health insurance plans offer a comprehensive set of essential health benefits such as maternity 

care, addiction treatment, and prescription drug coverage; 

Whereas pursuant to section 516 of title 28, United States 

Code, the conduct of litigation in which the United States 

is a party is reserved to the Department of Justice; 

Whereas public reports suggest that the President and his 

political advisors directed this course of action in direct 

contravention of the Department of Justice’s longstanding policy to defend Acts of Congress and duty to 

advance reasonable analysis of legal questions, for example— 

(1) when the Department of Justice changed its litigating position on June 7, 2018, in the Texas v. United 

States case to ask the court to strike down the ACA’s 

guaranteed issue and community rating requirements, 

thereby eliminating protections for people with pre-existing conditions and reinstating legal discrimination based 

on health status, that position was found to be so legally 

indefensible that three of the four career attorneys representing the Government refused to sign the relevant 

briefs and removed themselves from the case; and 

(2) when the Department of Justice again changed 

its litigating position on March 25, 2019, in the appeal 

of Texas v. United States to seek the invalidation of 

every provision of the ACA, it was reported that decision 

was made over the objections of both the Department of 

Justice as well as the Department of Health and Human 

Services; and 

Whereas the Trump Administration has proceeded in the 

Texas v. United States lawsuit with total disregard for 
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the consequences of its actions for the lives of millions of 

Americans: Now, therefore, be it 

Resolved, That it is the sense of the House of Representatives that— 

(1) the actions taken by the Trump Administration 

seeking the invalidation of the ACA’s protections for 

people with pre-existing conditions, and later the invalidation of the entire ACA, are an unacceptable assault on 

the health care of the American people; and 

(2) the Department of Justice should— 

(A) protect individuals with pre-existing conditions, seniors struggling with high prescription drug 

costs, and the millions of people in the United 

States who newly gained health insurance coverage 

since 2014; 

(B) cease any and all efforts to destroy Americans’ access to affordable health care; and 

(C) reverse its position in Texas v. United 

States, No. 19–10011 (5th Cir.). 

Attest: 

Clerk.