The AAMC, along with the American Hospital Association, the Federation of American Hospitals, the Catholic Health Association of the United States, and America’s Essential Hospitals, submitted an amicus brief in support of the constitutionality of the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152) in the case of Texas v. United States.
The AAMC previously submitted an amicus brief expressing concern about a number of provisions of the ACA that would be considered null and void if the plaintiffs were successful, including protections for patients with preexisting conditions [see Washington Highlights, June 15, 2018]. Since initial challenges to the ACA that started in 2011, the AAMC has submitted briefs in support of the ACA.
The brief follows a Dec. 14, 2018, ruling from the U.S. District Court for the Northern District of Texas that found that the individual mandate provision of the ACA is unconstitutional, since the penalty for failing to maintain minimum coverage was reduced by Congress to zero on Jan. 1. The court further ruled that the individual mandate could not be severed from the remaining provisions of the ACA, thereby invalidating the entire law. This case is on appeal to the U.S. Court of Appeals for the Fifth District.
The brief discusses the devastating effects that would result from a ruling that the ACA is unconstitutional, noting that the Congressional Budget Office (CBO) estimated that a near-complete repeal could cause 32 million people to lose health insurance over a ten-year period, a greater number of uninsured individuals than before the ACA. The brief details the impact of this loss of coverage stating that “without coverage, Americans suffer,” and that those “without insurance coverage forgo basic medical care, making them more difficult to treat when they do seek care.” It goes on to detail the impacts that repeal would have on hospitals, including an increased uncompensated-care burden, “which will force [hospitals] to reallocate limited resources and compromise their ability to provide needed services.”
The brief also discusses the important role of the ACA in addressing other health care needs, such as the opioid crisis, and in financing and fostering innovation. Finally, the brief argues that there should not be a “judicial repeal of the ACA,” but rather, a repeal if desired, should occur through Congress and not the federal court system.
A date for arguments before the Court of Appeals has not yet been set.