Recent Supreme Court Decisions Provide Wins for Health Care

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ACP supports recent SCOTUS decisions on LGBTQ rights, the DACA program and Reproductive Health Care

July 17, 2020 (ACP) – In the last days of its term, the U.S. Supreme Court issued four decisions that directly affect health care, and three of them align with the policy priorities of the American College of Physicians.

“The outcome is good in several cases, and we are proud to have played an important role in joining friend-of-the-court briefs that point justices toward rulings that protect patients,” said Bob Doherty, ACP senior vice president for governmental affairs and public policy. “But our work is far from over. The future of the Affordable Care Act (ACA) is on the line due to a legal challenge, and our advocacy work continues in all three branches of government – Congress, the courts and the White House.”

Here's a closer look at the Supreme Court's recent rulings.

LGBTQ Rights

In a landmark decision, the court ruled that gay, lesbian and transgender employees are protected from workplace discrimination under the 1964 Civil Rights Act. “The decision is a huge victory for the LGBTQ community and a major loss for the Trump administration, which had sided with employers in three cases before the court,” National Public Radio reported.

“While this wasn't a health care ruling, it's important to establish these civil rights protections,” Doherty said. “It bodes well for efforts to ensure persons are not discriminated against in health care. ACP has strong policy against discrimination in all aspects of society.”

However, the Trump administration recently reversed a policy set by the Obama administration that interpreted the ACA to forbid discrimination against transgender people. ACP opposed the decision.

DACA Protections

Nearly 650,000 undocumented immigrants who were brought to the United States as children will be able to stay in the country – for now – thanks to a Supreme Court ruling over the Deferred Action for Childhood Arrivals (DACA) program.

The Supreme Court blocked the cancellation of the DACA program, which protects undocumented individuals who were brought to the United States as children from being deported. As The Washington Post reported, the president's “administration has tried since September 2017 to end the program. It was implemented as an executive action by Obama in 2012 after a failed congressional attempt at comprehensive immigration reform.”

The ruling “is a huge win, but not a final win,” Doherty said. “In this case, the Supreme Court ruled that the administration did not follow proper procedures.”

ACP joined a friend-of-the-court brief to advocate for Dreamers and will continue its advocacy. “Ultimately, Congress needs to clarify in federal law that DACA recipients are protected and also provide a pathway to citizenship,” Doherty said. “We've been calling for Congress for years to do that, but realistically it's not likely to happen this year. It's likely to fall to the next Congress.”

Reproductive Health Care

The Supreme Court ruled that states can't require clinics that provide abortions to only hire physicians with hospital privileges. “The court ruled that the requirement creates an undue burden for women in terms of their access to reproductive services,” Doherty said. “We joined the American College of Obstetricians and Gynecologists and other groups to investigate, and we found there was no medical justification for the hospital privilege requirement. ACP was also involved in the case via signing onto a friend-of-the-court legal brief.”

Yet in a blow to the rights of patients and the ability of physicians to provide appropriate care, the Supreme Court ruled that employers are not required to provide access to no-cost contraception if they object on religious or conscience grounds.

“The government estimates that between 70,000 and 126,000 women could lose access to cost-free birth control as a result,” The Washington Post reported.

“Contraception is a medically necessary and appropriate health care service,” Doherty said. “We view this decision as wrongheaded in providing such a broad exemption from those requirements. It also creates a dangerous precedent for employers to opt out of covering other essential care. You could have a case where an employer decided not to cover vaccination or not cover treatment for a sexually transmitted disease because it violates their religious belief or conscience.”

ACP is keeping a close eye on another health care case – a challenge to the entire ACA. The Supreme Court is expected to address the case this fall. “We have increasingly been involved in court cases, and this one is crucial,” Doherty said. “We've joined in a friend-of-the-court brief to the Supreme Court, and we'll continue to argue that the ACA is vital for America's health. Our job is to speak up for patients and physicians, and we'll continue doing so.”

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