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Kentucky Attorney General Vows To Protect The Affordable Care Act

AILSA CHANG, HOST:

We're going to hear some reaction now to Friday's ruling from a federal judge in Texas striking down the entire Affordable Care Act as unconstitutional. At the moment, the ACA remains in place pending an appeal of this decision. The White House said on Friday that it expected the ruling to be appealed all the way to the Supreme Court. Attorneys general in more than a dozen states and the District of Columbia have vowed to defend the health care law.

And we're joined now by one of them, Democrat Andy Beshear, who's the current attorney general of Kentucky. He joins us now from Lexington. Welcome.

ANDY BESHEAR: Thank you for having me.

CHANG: You have said that if this decision is upheld, this ruling would be devastating to Kentucky. Explain why.

BESHEAR: If this ruling is upheld, more than 1.3 million Kentuckians could lose their coverage. That includes nearly 50 percent of all Kentuckians that have some pre-existing condition. It includes 500,000 Kentuckians that have health care coverage for the first time based on expanded Medicaid. It would cut over $50 billion that would flow into this state over the next 10 years through that program. It would allow insurance companies to discriminate against women and seniors, charging them more. And it would eliminate that very popular provision that allows young Kentuckians to stay on their parents' insurance until they're 26. But, Ailsa, when you have 1.3 million of your Kentucky families whose coverage is on the line, that is devastating.

CHANG: Of course you're raising these concerns at least so far in the absence of how Republicans would replace the Affordable Care Act if it is deemed unconstitutional ultimately. But let me just refer back to Judge Reed O'Connor's legal reasoning. He's the district court judge who had struck down the ACA. According to Judge O'Connor, when there's no tax penalty for someone who goes without health insurance, there's no longer any constitutional ground to uphold the rest of the health care law. What do you make of that legal reasoning? What would be your counterargument?

BESHEAR: Well, I think the legal reasoning is flawed and will ultimately be overturned by the appellate court. This is an attack that we've seen. They took the initial opinion by the Supreme Court, attempted to chip away at it and, once enough is chipped away, to come back to a judge that they believed would side with them to get it all tossed out. At the end of the day, I believe most all the provisions of the Affordable Care Act are severable.

CHANG: By severable, you mean if it's shown that the individual mandate doesn't rest on constitutional grounds, that doesn't threaten the survivability of the rest of the law.

BESHEAR: That's exactly right. You know, the individual mandate doesn't necessarily have anything to do with whether insurance companies can discriminate against women and seniors. The individual mandate doesn't have anything necessarily to do with the expansion of Medicaid, which has provided coverage for 17 million Americans nationwide.

CHANG: So it sounds like based on an earlier part of your answer that you are suggesting Republicans shopped around for a favorable court here, that they very much wanted this case to be heard by Judge Reed O'Connor because he has a track record for siding with Republicans when it comes to contentious policy issues. Is that what you're saying?

BESHEAR: I believe those that brought this case were willing to put politics above people's lives. In my state, where we're No. 1, 2 or 3 in heart disease and diabetes and lung cancer, these are necessary provisions to make sure that our families can just see a doctor, that we can break the cycle of poor health in Kentucky.

CHANG: President Trump easily won Kentucky in 2016. He's been quite vocal about his desire to get rid of the ACA. You are a Democrat in a state with a lot of Republican...

BESHEAR: (Laughter) I am.

CHANG: ...Representation in Washington. Is your determination to keep appealing this decision going to be unpopular?

BESHEAR: Well, I've learned that at the end of the day, in these jobs you've got to do the right thing. And when you do the right thing, I think people see it. And when there are 1.3 million Kentuckians that might lose their coverage, I think that they are going to be supportive of fighting for that coverage.

CHANG: Andy Beshear is Kentucky's state attorney general. Thank you very much for being with us today.

BESHEAR: Thanks for having me. Transcript provided by NPR, Copyright NPR.