ACP Takes Action Against Latest Court Challenge to Affordable Care Act

Advocate Masthead

Lawsuit would wreak havoc on health care, College maintains

Sept. 21, 2018 (ACP) – The American College of Physicians has joined other top medical groups in opposing a federal lawsuit that jeopardizes basic patient protections afforded by the Affordable Care Act.

The judge in the case, Texas vs. United States, heard oral arguments earlier this month in Austin, Texas, and could issue a ruling any day now.

The lawsuit “poses an existential threat to the law,” said Ryan Crowley, ACP's senior associate for health policy. “The worst-case scenario is that the court decides in favor of the plaintiffs, and the entire ACA is struck down. This would trigger immediate instability in the insurance market and cause millions to lose their health insurance coverage, endangering the patient-physician relationship.”

The lawsuit, filed by 20 Republican-led states, is based on the argument that “the entire health care law was rendered unconstitutional after Congress repealed the ‘individual mandate’ that required most Americans to buy insurance or risk a tax penalty,” The New York Times has reported.

ACP is deeply concerned that the lawsuit could lead to the demise of the ACA, eliminating protections for patients such as guaranteed coverage for people with pre-existing conditions and bans on annual and lifetime coverage limits.

In June, ACP joined with the American Medical Association, the American Academy of Family Physicians, the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry to file an amicus curiae (“friend of the court”) brief in the case.

The brief warns that eliminating the ACA will “wreak havoc on American health care” and says it's up to Congress, not the courts, to determine how to adjust the law.

The brief also points out that the ACA's nationwide protections for Americans with pre-existing health conditions have played a “key role” in allowing 3.6 million people to obtain affordable health insurance.

“Severing those vital insurance reforms would leave millions without much-needed insurance,” the brief says.

Indeed, Crowley said that “the Urban Institute estimates that if the ACA were eliminated, the number of uninsured would rise by 17.1 million in 2019.”

It's also possible, he said, that the court could strike down specific regulations, such as those that moderate insurance premiums or prevent insurers from denying coverage.

ACP believes that a ruling that favors those who brought the lawsuit would, in essence, be turning back the clock on federal health policy, making it harder for patients to access care and for physicians to treat them.

Not only could protections for patients with pre-existing conditions be eliminated, ACP noted, but young people could no longer be covered by their parents' health insurance till age 26, and annual and lifetime dollar limits on insurance coverage could be reinstated.

The lawsuit, and potential outcomes from it, have sparked some odd twists. For instance, Wisconsin Gov. Scott Walker – a Republican whose state joined the lawsuit – has promised to retain protections for pre-existing conditions for Wisconsin residents even if the ACA were repealed.

In another twist, the Justice Department under the Trump administration has refused to defend the ACA. That task has fallen to attorneys general from states led by Democrats.

ACP also hopes that the judge in the case, U.S. District Judge Reed O’Connor, will reject the lawsuit's demand for a preliminary injunction, not allowing actions to occur until appeals have been exhausted. Any ruling is likely to be appealed, and the case may make it way to the U.S. Supreme Court.

More Information

ACP's statement on the amicus curiae filed in the case of Texas vs. the United States can be read here.

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Back to the September 21, 2018 issue of ACP Advocate