Medical Groups Come Out in Force to Defend ACA in Lawsuit

Soon after Attorney General Jeff Sessions announced that the Justice Department would not defend the Affordable Care Act in a closely watched federal court case, numerous associations in the medical space and beyond threw their support behind the law in a series of amicus briefs.

Although the Justice Department has chosen not to defend portions of the Affordable Care Act in court, a variety of associations are speaking up in a federal lawsuit that challenges the law’s constitutionality.

That case, filed by 20 Republican-led states in a Texas district court, is the latest move by opponents to stop the law, even after multiple trips to the Supreme Court and several failed attempts in Congress to repeal it. The plaintiff states argue that because lawmakers repealed the individual mandate provision as part of last year’s tax reform legislation, the ACA as a whole is now unconstitutional. DOJ doesn’t go that far, but it declined to defend the law, saying that without the individual mandate, the provision requiring insurance companies to provide coverage for preexisting conditions at standard rates is now invalid.

But last week, numerous groups representing different players in the healthcare industry—including hospitals, doctors, patient advocates, and health insurers—rallied to the law’s defense in a series of friend-of-the-court briefs in Texas v. United StatesThe 11 briefs touch on different parts of the law and reflect a variety of interests but demonstrate broad support in the medical world for keeping the law intact.

“The ACA’s repeal may serve plaintiffs’ idiosyncratic health-policy preferences,” the American Hospital Association [PDF] and other groups write in their brief. “But for the rest of the country, which has received from the act expanded health insurance coverage, a stable individual-insurance market, and an expanded Medicaid safety net, a judgment for plaintiffs would be disastrous.”

The American Medical Association and a number of other physician groups argue that Congress, not the courts, should resolve the issues raised in the lawsuit.

The medical groups “have acknowledged that the ACA has flaws and policymakers need to fix the problems, gaps, and unintended consequences of this law,” the AMA’s brief states [PDF]. “They have consistently advocated that position before Congress. But they disagree with any attempt to erase key features of the ACA.”

Also filing amicus briefs were the insurance industry group America’s Health Insurance Plans (AHIP), AARP, and a variety of health organizations, including the American Cancer Society, the American Heart Association, and the American Lung Association.

“At bottom, plaintiffs seek to turn off the health insurance system as we know it with the flip of a switch,” AHIP’s brief states [PDF]. “The ACA’s scale and scope make that impossible. Accordingly, this court should deny a preliminary injunction.”

A group of five law professors also filed a joint brief opposing the goals of the lawsuit—a group who were noted for previously having diverging opinions on the law. “Congress told us what it wanted through its 2017 legislative actions. … It repealed the penalty while leaving the insurance reforms in place,” the scholars write.

Last week, Attorney General Jeff Sessions announced the Justice Department would not defend the Affordable Care Act’s individual mandate, breaking with the usual practice of the federal government supporting laws passed by Congress, if challenged in court, regardless of the policies they contain.

(chatsimo/iStock/Getty Images Plus)

Ernie Smith

By Ernie Smith

Ernie Smith is a former senior editor for Associations Now. MORE

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