Provider and payer groups told the Supreme Court that invalidating the Affordable Care Act (ACA) would completely wreck a healthcare system already under stress by the COVID-19 pandemic.
Several major groups filed “friend of the court” legal briefs Wednesday in a federal lawsuit brought by Texas and 17 other red states seeking to get rid of the ACA. A prevailing theme throughout the briefs is that jettisoning the healthcare law would create chaos and strain the healthcare system.
“Invalidating provisions that have expanded access to health insurance coverage such as the guaranteed-issue and community rating provisions—or the entire ACA—would have a devastating impact on doctors, patients, and the American health care system in normal times,” the brief from the American Medical Association and several other physician organizations said.
But striking down the ACA when the system is struggling to respond to COVID-19 would be a “self-inflicted wound that could take decades to heal.”
The brief in the case called California vs. Texas said that major protections for patients are in danger, including protections for preexisting conditions and the Medicaid expansion.
Enrollment in Medicaid is expected to increase as unemployment skyrockets due to the pandemic. Payers were also concerned about the sudden interruption of coverage that would occur due to the invalidation of the ACA.
“Now, more than ever, we need access to quality, affordable coverage,” said Margaret Murray, CEO of the Association for Community Affiliated Plans, which represents 75 nonprofit plans.
A collection of hospital groups also wrote that the increase in the uninsured would “strain the resources of hospitals, particularly those that serve low-income and rural populations.”
The American Hospital Association, the Federation of American Hospitals, the Association of American Medical Colleges and America’s Essential Hospitals signed on to the brief.
America’s Health Insurance Plans (AHIP), a major insurance lobbying group, challenged the main argument of the lawsuit in the case.
The 18 red states argue that the individual mandate’s penalty was zeroed out as part of the tax reform law passed in 2017. The lawsuit argues that the mandate is unconstitutional and therefore the rest of the law should go down with it.
A group of blue states is leading the effort to defend the law in court after the Department of Justice agreed with the lawsuit’s goal of defeating the ACA.
An appeals court found late last year that the mandate was unconstitutional but punted on the decision on whether the rest of the law should continue. The blue states then appealed to the Supreme Court, which agreed to hear the challenge in March.
AHIP said 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.”