AHIP Files Amicus Brief in Texas v. United States

May 14, 2020 at 02:09 pm by Staff


AHIP filed an amicus brief with the U.S. Supreme Court in Texas v. United States, the lawsuit filed by a Texas-led group of states and several individuals challenging the constitutionality of the Affordable Care Act (ACA) following the zeroing out of the individual mandate penalty. Read the brief.

Here are a few highlights from the brief:

"Since its passage in 2010, the ACA has transformed the nation's health care system. It has restructured the individual and group markets for purchasing private health care coverage, expanded Medicaid, and reformed Medicare. Health insurance providers (like AHIP's members) have invested immense resources into adjusting their business models, developing new lines of business, and building products to implement and comply with those reforms. As a result, 20 million more Americans--including those with preexisting conditions--now have affordable coverage for the first time, and millions more enjoy better and more comprehensive coverage."

"Make no mistake: invalidation of the ACA would wreak havoc on the entire health care system. Congress could not have intended that result in 2010, when it enacted one of the most comprehensive and far-reaching pieces of health care legislation in over 50 years. And Congress did not intend that result in 2017, when it zeroed out the tax payment for forgoing health coverage without repealing any other ACA provision."

"A finding of inseverability would also undo scores of reforms that have reset the American public's expectations about the availability, value, and scope of health care coverage. To name a few: It would eliminate guaranteed coverage for individuals with preexisting conditions; the assurance that young adults can stay on their parents' plans until age 26; the prohibition on annual or lifetime benefit limits; and the provision of preventative care at no out-of-pocket cost. It would abolish the ACA's premium tax credits, on which millions of people now rely to obtain affordable coverage. And it would cut off billions in funding for expanded Medicaid programs in 36 states and the District of Columbia, jeopardizing the coverage of the 13 million newly eligible people they cover. Rolling back the ACA's Medicare reforms-- including resurrecting Medicare Part D's prescription drug "donut hole" and rescinding key payment changes--would cast a cloud of uncertainty over the health care of seniors and disabled individuals."

"These sobering consequences of COVID-19 put into stark relief the fact that the ACA's provisions continue to function meaningfully--and, indeed, are indispensable--separate and apart from a (currently unenforceable) individual mandate."

"At bottom, whether viewed on its own terms or through the instructive lens of the pandemic, the ACA is not a tapestry that unravels by pulling upon a single individual-mandate thread. Quite the opposite, the ACA's multitude of wide-ranging reforms, which rest on a variety of statutory foundations scattered across the U.S. Code, affect every health insurance market (not just the individual market) and every American with coverage (not just those who purchased coverage on the exchanges)."

"In short, the ACA has shifted the paradigm for health care coverage in this country. It has extended quality, affordable coverage to tens of millions of American families--regardless of their health status--through a complex and comprehensive set of reforms. No industry has been more directly impacted by the ACA than health insurance providers, which have invested vast resources to participate in the relevant markets, comply with the law's myriad reforms, and organize their businesses to operate in a revamped health care system. This Court should not countenance the unwarranted attempt to sweep that all away."

Sections: Regulatory/Compliance