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AMA, physician groups defend ACA gains in new California v. Texas filing


 

CHICAGO - Amid a global health crisis and in defense of significant coverage gains and key patient protection provisions within the Affordable Care Act (ACA), the American Medical Association (AMA) and other leading physician organizations filed an amicus brief with the U.S. Supreme Court in the case of California v. Texas. In the filing, amici cite significant evidence Congress never intended to invalidate the entire ACA, and that even if the Supreme Court determines the Individual Mandate is invalid, the rest of the ACA should remain intact.

"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 amici write. "However, striking down the ACA at a time when the system is struggling to respond to a pandemic that has infected nearly 1.4 million Americans and killed nearly 80,000 at the time of this writing would be a self-inflicted wound that could take decades to heal."

If the Supreme Court allows the 5th Circuit's decision to stand, the fate of the ACA will remain uncertain while the district court determines which provisions may remain in effect and which might not. The following protections hang in the balance:

  • Patients would no longer have protections for pre-existing conditions, including COVID-19
  • Children would no longer have coverage under their parents' health insurance plan until age 26
  • Insurers would no longer be held to the 85% medical loss ratio, meaning they could generate higher profits at the expense of coverage and payments for services
  • 100 percent coverage for certain preventive services would cease
  • Individual marketplace and premium subsidies based on income would be eliminated
  • Medicaid eligibility expansion would end, as would federal funding for Medicaid expansion
  • Annual and lifetime dollar limits could be reinstated, leading to more bankruptcies due to health care costs

For more than a decade, the AMA has advocated for expanded coverage and key health insurance reforms to help patients. The AMA's highest priority is to ensure that the many millions of Americans who have gained health care coverage because of the law maintain their coverage, in addition to their patient protections.

Additional organizations joining the AMA include the American Academy of Allergy, Asthma and Immunology, Aerospace Medical Association, American Academy of Family Physicians, American Academy of Pediatrics, American College of Cardiology, American College of Emergency Physicians, American College of Obstetricians and Gynecologists, American College of Physicians, American College of Radiation Oncology, American College of Radiology, American Psychiatric Association, American College of Medical Genetics and Genomics, American Society of Metabolic and Bariatric Surgery, Endocrine Society, GLMA: Health Professionals Advancing LGBTQ Equality, Renal Physicians Association, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, American Society of Gastrointestinal Endoscopy, and the American Society of Hematology.

 
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