Several patient groups and associations, including the American Cancer Society, American Diabetes Association, American Heart Association, Crohn’s & Colitis Foundation, and the Cystic Fibrosis Foundation, and others, have issued a joint statement today1 to urge the Fifth Circuit Court of Appeals to prioritize patient protections as it presides over arguments in the case Texas v United States.

In April 2018, 20 states, including Texas, and 2 individual plaintiffs filed a complaint in the United States District Court for the Northern District of Texas; they argued that the Patient Protection and Affordable Care Act’s (ACA) individual mandate provision is unconstitutional, and that because the rest of the ACA is inseparable from this provision, this act must be repealed as well.2 On March 25, 2019, the House of Representative of the 116th Congress (previously granted a motion to intervene as a defendant by the Fifth Circuit Court) filed its opening brief; they highlighted that 1) the plaintiffs lacked standing to challenge the ACA, 2) in its amended form the individual mandate provision is constitutional, 3) the ACA is separable from the individual mandate provision.

On April 1, 2019, the aforementioned patient groups filed an amicus brief to assert the intent of the ACA’s creation was to aid in protecting critically ill patients, and those with preexisting, chronic diseases, and that a rejection of efforts to repeal or replace the ACA would confirm this intent. The amicus highlights “statistics [that] confirm the virtual certainty that all Americans will need health care at some point in their lives to combat … serious chronic diseases or a myriad of other health conditions. Without affordable, accessible health insurance, patients and their families must bear the burden of substantial health-care costs and later-stage diagnoses, as well as risk being denied the lifesaving care they need.”3 In fact, the ACA has provided increased healthcare coverage and access for 606, 277 adults. After review of this, in conjunction with many other studies and financial and epidemiologic data, as well as multiple lengthy debates, Congress demonstrated an explicit unwillingness to leave millions of Americans without healthcare coverage, which would incur costs up to $207,000,000,000 annually; in its invalidation of the entirety of the ACA, the lower court clearly substituted its judgment in place of the policy-based decision made by Congress. 

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In a press release on July 9, these patient groups issued a joint statement. They call on the Fifth Circuit Court to note that the lower court’s ruling could result in healthcare coverage denial, arbitrary limits on coverage, as well as exclusions of entire categories of medical care (such as prescription medications).1 In addition, approximately 8 million people may lose their tax credits which allow these people to afford healthcare coverage on the open market, and millions more may potentially be dropped from Medicaid. These effects are known to disproportionally affect people who have acute and serious illnesses, women during pregnancy, and those with chronic medical conditions such as cancer, diabetes, substance abuse issues, and heart, lung, and neurologic diseases.

The statement concluded with the reminder that the effects of invalidating the patient protections included in the ACA “would be profound and immediate” on approximately 27 million people by next year.

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References

  1. Court urged to prioritize patients and uphold health care law [news release]. American Heart Association; July 9, 2019. https://newsroom.heart.org/news/court-urged-to-prioritize-patients-and-uphold-health-care-law
  2. Constitutional Accountability Center. Texas v. United States. https://www.theusconstitution.org/litigation/texas-v-united-states/. Accessed July 9, 2019
  3. The United States Court of Appeals for the Fifth Circuit. On Appeal from the United States District Court for the Northern District of Texas, Fort Worth Division. 2019. https://www.fightcancer.org/sites/default/files/National%20Documents/Amicus%20Filing.pdf. Accessed July 9, 2019.

This article originally appeared on Medical Bag