Sen. Joni Ernst has been blunt about her hostility toward the Affordable Care Act and her vote to repeal it. But while Congressional Republicans, including Ernst, have yet to succeed in repealing the law, they are quietly undermining the future of accessible health care along with a raft of other health and safety provisions – simply by voting for Donald Trump’s judicial nominees. And that connection often goes unnoticed.
It was a Trump judge in the Fifth Circuit, Kurt Engelhardt, who recently cast the deciding vote to rule that the individual mandate of the Affordable Care Act (ACA) is unconstitutional, threatening the ACA for millions of Americans. Ernst cast a vote to confirm Engelhardt, just as she has voted for virtually every Trump judicial nominee who has come her way in her Senate career.
And what a parade it has been. At least 19 other lifetime federal judges nominated by Trump already had anti-ACA records at the time of their nomination. This includes a dozen powerful Trump appellate court judges who have opposed the ACA or argued it is unconstitutional, and one who filed a Trump Administration anti-ACA brief in the pivotal Fifth Circuit case, United States v. Texas, itself.
So far, Engelhardt is the only judge to rule directly on the ACA since his appointment by Trump. But you don’t have to look far to find other rulings by Trump appointees that strike at the heart of our ability to access the care we need, and to be treated with dignity when we do so.
Among them: a vote by Trump judge Joan Larsen in favor of upholding an insurance company’s denial of disability benefits to a cancer patient; a vote by Trump judge Amy Coney Barrett to dismiss an injured patient’s malpractice suit, apparently because she didn’t have a lawyer; and a vote by Trump judge John Bush to uphold a law forcing women to undergo medically useless (and potentially harmful) procedures before an abortion.
In yet another alarming instance, a Trump judge supported by Ernst – Ralph Erickson – cast the deciding vote to dismiss a Medicare fraud case against an Iowa hospital. In that case, employees at Crawford County Memorial Hospital claimed the hospital was administering – and billing Medicare for – breathing treatments that patients did not need. They also documented other types of billing fraud. But Erickson cast the deciding vote to dismiss the employees’ lawsuit, arguing that the 55 paragraphs of “specific and detailed allegations” of fraud in their complaint were not precise enough.
The list goes on, as does the list of cases in which Trump judges – virtually all supported by Ernst – have ruled against health and safety regulations affecting consumers and workers. In these cases, judges have shown their deep hostility to the entire social safety net.
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Taken to its logical extreme, this is a way of thinking that includes eliminating not just the ACA and lifeline programs like Social Security and Medicare. It means scrapping federal and state laws and agencies that are designed to ensure that only safe and effective drugs are put on the market; that there is a minimum wage, a forty-hour work week, and an opportunity for workers to bargain with their employers; that factories do not dangerously pollute the air we breathe and the water we drink; that discrimination based on race, gender, and other characteristics does not cut off people’s life opportunities; that health and safety on the job is protected; and much more.
It’s a way of thinking that is deeply harmful to the most vulnerable people in our society. Ernst’s votes to confirm Trump judges who embrace it make her wholly complicit in that harm.
So just because Ernst and fellow Republicans haven’t succeeded in their much-trumpeted goal to repeal the ACA – we shouldn’t underestimate the damage she’s doing to Iowans’ health and safety through judicial confirmations. It is a shameful legacy.
Elliott Mincberg, Senior Fellow, People for the American Way and Matt Sinovic, Executive Director, Progress Iowa.