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 Dis-
trict 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 Depart-
ment of Justice— 
(1) would not defend the constitutionality of the 
minimum essential coverage provision; and 
(2) would argue that provisions protecting individ-
uals with pre-existing conditions (specifically the provi-
sions 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 sev-
erable from the remaining provisions of the ACA’’, indi-
cating 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 es-
sential 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 condi-
tions were routinely denied health insurance coverage, 
subject to coverage exclusions, charged unaffordable pre-
mium rates, exposed to unaffordable out-of-pocket costs, 
and subject to lifetime and annual limits on health insur-
ance 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 exorbi-
tant price had they needed individual market health in-
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surance prior to 2014, or had coverage for their pre-ex-
isting 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 condi-
tions, he has ordered his Department of Justice to ac-
tively pursue the destruction of these protections in Fed-
eral 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 argu-
ment before the court, insurers would be allowed to im-
pose an unlimited ‘‘age tax’’ on the health insurance pre-
miums of older Americans; 
Whereas prior to 2010, Medicare enrollees faced massive out- 
of-pocket prescription drug costs once they reached a cer-
tain 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 pre-
scribed medicines because of the cost, if the Trump Ad-
ministration 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 ex-
panding Medicaid to individuals with incomes up to 138 
percent of the Federal poverty level, providing health cov-
erage to more than 12 million newly eligible people; 
Whereas if the Trump Administration succeeds in its argu-
ment 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 in-
dividual health insurance coverage affordable for millions 
of people in the United States for the first time; 
Whereas if the Trump Administration succeeds in its argu-
ment before the court, the health insurance individual ex-
changes 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 exorbi-
tantly; 
Whereas if the Trump Administration succeeds in its argu-
ment before the court, people in the United States would 
lose numerous consumer protections in their coverage, in-
cluding the requirements that— 
(1) plans offer preventive care without cost-sharing; 
(2) young adults have the option to remain on a par-
ent’s insurance plan until age 26; and
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(3) many health insurance plans offer a comprehen-
sive set of essential health benefits such as maternity 
care, addiction treatment, and prescription drug cov-
erage; 
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 long-
standing policy to defend Acts of Congress and duty to 
advance reasonable analysis of legal questions, for exam-
ple— 
(1) when the Department of Justice changed its liti-
gating 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-exist-
ing 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 rep-
resenting 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 Represent-
atives 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 invali-
dation 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 condi-
tions, 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 Ameri-
cans’ access to affordable health care; and 
(C) reverse its position in Texas v. United 
States, No. 19–10011 (5th Cir.). 
Attest: 
Clerk.