On June 7, the Department of Justice (DOJ) announced that it would not elect to defend several critical patient protections provided by the Affordable Care Act (ACA), according to a joint press release issued by the American Diabetes Association, the American Cancer Society Cancer Action Network, the American Heart Association, the American Lung Association, and the National Multiple Sclerosis Society.1

Led by Texas Attorney General Ken Paxton, 20 states have filed a lawsuit challenging the ACA in Texas federal court, arguing that the ACA is invalid after the Congressional repeal of the individual mandate tax legislation in December 2017. In particular, the plaintiffs take issue with key protections for Americans with preexisting conditions. Under the ACA, these patients cannot be charged more for health insurance on the basis of their health status or denied coverage because of a preexisting condition.

Typically, the DOJ is tasked with defending US federal laws. However, Attorney General Jeff Sessions has elected to support the case brought by the plaintiffs. In a letter to congressional leaders, AG Sessions called the Texas lawsuit and the DOJ response a “rare case where the proper course is to forgo defense” of the law.2

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A joint statement issued by the American Diabetes Association and others stated:  “The decision by the Department of Justice to abandon critical patient protections is devastating for millions of Americans who suffer from serious illness or have preexisting conditions and rely on those protections under current law to obtain life-saving health care.

“Members of Congress on both sides of the aisle have been emphatic that critical protections should not be repealed without a replacement that would ensure patients can continue to have access to care. If the court strikes down these protections, that exact repeal without replace scenario will occur.”1

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In response, California Attorney General Xavier Becerra pledged to lead the fight to protect the ACA, joining with 16 other Attorneys General from around the country to fight the lawsuit in court.3

“The Texas lawsuit is based on a dubious legal claim with the sole goal of stripping Americans of their healthcare,” he said in a statement. “In California, millions of people receive quality, affordable healthcare under the ACA, many for the first time. In addition, the proponents of the Texas lawsuit want to eliminate the preventive care and prescription drug benefits for working families, seniors and people with disabilities. To roll back the clock and risk the health of millions of Americans is irresponsible and dangerous. We can’t and we won’t go back.”4


  1. Justice Department argues to roll back critical patient protections in health care law [news release]. Arlington, VA: American Diabetes Association. http://www.diabetes.org/newsroom/press-releases/2018/justice-dept-roll-back-patient-protections.html. Published June 8, 2018. Accessed June 11, 2018.
  2. Letter from Attorney General Jeff Sessions to Speaker Paul Ryan. Re: Texas v. United States, No. 4:18-cv-0067-O (N.D. Tex.). https://www.justice.gov/file/1069806/download. Published June 7, 2018. Accessed June 11, 2018.
  3. Bartolone P. California’s Attorney General vows to national fight to defend the ACA. Kaiser Health News. https://khn.org/news/californias-attorney-general-vows-national-fight-to-defend-the-aca/. Published June 11, 2018. Accessed June 11, 2018.
  4. Attorney General Becerra, joined by 16 AGs, moves to defend the Affordable Care Act against federal lawsuit filed in Texas [news release]. https://oag.ca.gov/news/press-releases/attorney-general-becerra-joined-16-ags-moves-defend-affordable-care-act-against. Sacramento, CA: State of California Department of Justice. Accessed June 11, 2018.