After vowing to strike down Obamacare and implement a replacement that will enshrine the GOP as the “party of health care,” President Donald Trump is off to a rocky start this week. In quick succession, he was dealt two major health care blows in the courts.

On Thursday, a federal judge blocked so-called “association health plans” (AHPs) — an avenue that Trump has long touted as a method of providing “tremendous health care at very small cost.”

U.S. District Judge John D. Bates ruled late Thursday that these health plans — cheaper, skimpier alternatives to insurance plans offered on the Obamacare marketplace — were “clearly an end-run” around the protections provided by the Affordable Care Act (ACA).

“Indeed, as the President directed, and the Secretary of Labor confirmed, the Final Rule was designed to expand access to AHPs in order to avoid the most stringent requirements of the ACA,” Bates wrote.


Under the Trump administration’s AHP proposal, associations would be able to form health plans based on shared geography or industry in order to provide insurance to small businesses or self-employed people. As ThinkProgress previously reported, experts contend that the policy leaves people vulnerable to junk insurance, given the minimal oversight. AHPs are not required to cover essential health benefits, like maternal care, mental health care, substance use disorder services, and prescription drugs.

Bates’ ruling is the second court decision this week to hamper the Trump administration’s major health policy proposals.

On Wednesday, a federal judge struck down Medicaid work requirements in Arkansas and Kentucky, arguing that the administration failed to justify the need for the work rules given the number of low-income people who would lose their health coverage as a result.

Despite Trump’s promise to deliver on health care with Republican proposals, over the course of his presidency, most of his big ideas have failed.

The Republican Party will become “The Party of Healthcare!” — Donald J. Trump (@realDonaldTrump) March 26, 2019

Earlier this year, a federal judge blocked the administration’s rollback of Obamacare’s birth control mandate, ensuring employers cannot refuse to cover employees’ birth control due to religious or moral objections. Lawsuits challenging Trump’s short-term health plans and his cuts to insurance subsidies that offset the cost of covering lower-income people have also made their way to courts, resulting in numerous losses for his administration. And a recent lawsuit against the administration’s family planning gag rule, a policy that would bar any Title X-funded clinic from providing or referring women and gender minorities for abortion, will likely at least delay implementation of the regulation.


Top Republicans in Congress don’t seem eager to dive back into a health care policy fight. On Thursday, Politico reported that Senate Majority Leader Mitch McConnell (R-KY) has distanced himself from the president’s recent health care rhetoric.

“The leader is sort of anxious to see what the president and his team put forward in terms of a proposal,” Sen. John Thune (R-SD) told Politico.