California Lawyer Normal Points Assertion in Protection of the Inexpensive Care Act

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becerra official ca ag

California and its coalition of 20 states and D.C. will defend the ACA in U.S. Supreme Court on November 10, 2020 

November 10, 2020 – SACRAMENTO — California Attorney General Xavier Becerra on Monday issued a statement on the Affordable Care Act (ACA) ahead of tomorrow’s oral arguments before the United States Supreme Court in the healthcare repeal case, California v. Texas. The California Attorney General’s Office is leading a coalition of 20 states and the District of Columbia in defense of the ACA including the law’s protections for people with preexisting conditions, public health investments, and Medicaid expansion, among others. In the midst of rising COVID-19 cases and deaths nationwide, the Trump Administration and the Texas-led state coalition are risking the healthcare of millions of Americans and financial support for states. The State of California alone, would stand to lose an estimated $160.2 billion in federal program funding, and millions of people would lose their healthcare coverage as a result of the loss of the ACA. 

“COVID-19 has made one thing undeniable: we must safeguard the Affordable Care Act — lives depend on it,” said Attorney General Becerra. “Every nation around the world has had to confront the devastating impact of the global pandemic. The United States, under President Trump’s watch, continues to set records going in the wrong direction. Millions infected, hundreds of thousands dead. As if on cue, the Trump Administration cavalierly continues its march to dismantle the ACA and strip Americans of their healthcare. We will do everything we can to defeat this unprecedented assault on a critical federal law by a sitting President.”

“The thought of reversing the gains experienced under the ACA, especially as we continue to battle the COVID pandemic, a public health crisis, is unconscionable,” said Dr. Jamila Perritt, President & CEO of Physicians for Reproductive Health. “Decreasing access to coverage for life saving health care in our communities is not only irresponsible, it is dangerous. It favors ideology over science. It places politics over people. It is wrong.”

“Dismantling the Affordable Care Act in the midst of a resurgent COVID-19 pandemic is not only reckless, but also illegal. Millions of Americans rely on health care they access through the ACA and this vital safety net must stay in place,” said Pennsylvania Attorney General Josh Shapiro, who filed an amicus brief in May in support of the efforts to defend the ACA. “My office stood up for the 1.2 million Pennsylvanians who rely on protections in the ACA — from allowing young adults to stay on their parents health insurance to protections for people with preexisting conditions, from diabetes and cancer to COVID.”

“Dismantling the ACA in the middle of a pandemic is foolish, and would have dire consequences for local governments and the communities we serve,” said James R. Williams, Santa Clara County Counsel, regarding the brief of the County of Santa Clara, the City of Chicago, and 42 counties, cities, and towns. “The ACA has allowed communities across the nation to dramatically improve the quality of healthcare, while reducing costs to taxpayers. Undoing the ACA now would endanger lives, imperil urgent efforts to manage the COVID-19 crisis, and leave our residents, cities, and counties on the hook for millions of dollars in costs we cannot afford.” 

“The ACA extended health coverage to millions of historically uninsured and vulnerable people in Los Angeles,” said Dr. Christina Ghaly, Director of Health Services, Los Angeles County. “Whether it was people experiencing homelessness, those with pre-existing conditions, or anyone between the age of 18 and 65 who simply could not afford it, the ACA meant coverage for an essential set of health benefits. With coverage came better and more innovative treatment models along with revenue to safety net providers. To lose the ACA would be destabilizing for us and devastating to the people we serve.”  

“The Affordable Care Act put our country on the right path toward healthcare justice. It’s unconscionable that in the middle of a pandemic, the Trump administration and its Republican allies are fast-tracking their mission to sabotage forward progress and rip away healthcare from working people,” said SEIU Local 121RN President Dr. Nina Wells, DNP, MSN-NE, RN, PHN. “As a nurse, I see the devastating impact healthcare costs have on families. No one should have to forego care to put food on the table, but it’s an impossible choice millions of Americans must make every single day. Hearing this lawsuit against the backdrop of one of the worst public health crises in our country’s history, the Supreme Court has an opportunity — and responsibility — to end this administration’s brutal attack on American lives once and for all.” 

“Knowing firsthand the importance of the Affordable Care Act, California’s hospitals are grateful for the Attorney General’s unwavering commitment to the invaluable protections it provides to millions throughout the state,” said Carmela Coyle, President & CEO of the California Hospital Association. “The ACA is a lifeline that secures not only access to essential health care services, but also the peace of mind that comes with knowing that care will be provided when it is needed. Without the ACA, Californians who rely on its protections will be sicker, impaired in their ability to provide for their families, and left without a viable path toward a healthier, more fruitful life.” 

“Particularly in the middle of a public health crisis and with COVID-19 cases at an all-time high, this lawsuit poses an immediate threat to the lives, health and wellbeing of people across the country,” said American Medical Association President Susan R. Bailey, M.D. “As we explained in our amicus brief to the Court, this lawsuit threatens to strip 20 million Americans of health insurance coverage and end numerous patient protections that enjoy broad, bipartisan support and have improved the lives of patients. Congress passed the ACA to improve the health of our nation, and we urge the court to reject this attempt to diminish its protections.” 

“It cannot be overstated how devastating the consequences of abolishing the Affordable Care Act would be,” said Frederick Isasi, Executive Director of Families USA. “Because of the reforms the ACA enacted, over 20 million people have gained access to health and health care through Medicaid and the marketplace. With record numbers of people losing employer-sponsored health insurance during this pandemic, it is especially important that they have access to those options. Many millions more get vaccines and preventive care, and 135 million people with pre-existing conditions have necessary protections thanks the ACA. Those protections are vital now more than ever, as 9.4 million people have been infected with COVID-19, which could be considered a pre-existing condition. They could be denied coverage, charged more, or denied crucial benefits without the ACA’s protections.”

“The Affordable Care Act was a big win for kids, opening doors to health coverage for millions of families across the country. From coverage for pre-existing conditions and for former foster youth, to well-child visits at no cost, to reduced maternal and infant mortality rates, children’s lives have drastically improved because of the ACA and would suffer if the law were dismantled,” said Mayra E Alvarez, President of The Children’s Partnership. “It is never the time to take away the health coverage of millions of children and families, but during the COVID-19 pandemic would be particularly heartless.”

“Striking down the ACA would be devastating to Medicare and the older adults and people with disabilities who rely on it,” said Alice Bers, Litigation Director at the Center for Medicare Advocacy. “The ACA provides Medicare beneficiaries with critical protections, including savings on prescription drugs, free preventive care, and protection from discrimination. Losing the ACA would also damage Medicare’s financial stability, putting the promise of Medicare for future beneficiaries in danger.”

“Striking down the Affordable Care Act (ACA) in the midst of this public health and economic crisis would cause grave harm,” said Robert Greenstein, President of the Center on Budget and Policy Priorities. “An estimated 21 million people would lose coverage, worsening access to care, financial security, racial disparities and health outcomes. It would also impede efforts to address the public health crisis. And eliminating the ACA’s protections for people with pre-existing conditions would make it harder for the tens of millions of people with pre-existing conditions to get comprehensive coverage, including the millions of people who’ve had COVID.” 

“Legal scholars agree that sound legal principles require the Court to uphold the Affordable Care Act in its entirety,” said William B. Schultz, former general counsel for the U.S. Department of Health and Human Services who filed an amicus brief on behalf of 36 state hospital associations. “The ruling sought by Texas and other states would have a devastating impact on the delivery of healthcare in the United States and undermine the ability of hospitals to deliver high quality services at a time when hospitals are under enormous stress due to the coronavirus pandemic,” 

“The U.S. Supreme Court should not invalidate the Affordable Care Act,” said Scott P. Serota, CEO and president of the Blue Cross Blue Shield Association. “To do so would strip vital protections from consumers no matter where they get their health insurance coverage – through an employer, Medicare and Medicaid, or the individual marketplaces that were created under the law. The ACA is particularly critical now for millions of the newly unemployed and their families, ensuring they still have access to quality and affordable health insurance coverage during a severe public health crisis.”

“Among other things, the ACA contained a provision creating the regulatory pathway for the FDA to approve biosimilars, more affordable alternatives to biologic medicines. That pathway was urgently needed because biologics account for approximately 40% of all prescription drug spending, said Jeffrey K. Francer, Senior Vice President & General Counsel of the Association for Accessible Medicines. “Collectively, biosimilars are expected to deliver at least $54 billion in savings to patients and taxpayers by 2027. Invalidating the biosimilars regulatory pathway would risk this enormous savings and further set the United States behind other countries in our ability to lower prescription drug prices.”

“The far reaching provisions of the Affordable Care Act give people with disabilities an equal opportunity to buy and keep good private health insurance, and incentivize the provision of community-based services rather than institutional care revealed by the pandemic to be deadly,” said Silvia Yee, Senior Staff Attorney, Disability Rights Education and Defense Fund. “The Supreme Court will be looking not only at the severability of the law but of disabled lives.” 

“Young adults have seen the greatest gains of any age group thanks to the ACA,” said Erin Hemlin, Health Policy and Advocacy Director, Young Invincibles. “The uninsured rate has been cut in half, from 30 percent to 15 percent, and millions have gained access to critical benefits like maternity care and mental health care. The ACA not only provides life-saving health coverage, it also provides financial security to millions more young people who are beginning their independent lives, and need the peace of mind that health coverage can provide during such uncertain times. The ACA is a lifeline that touches nearly every American, to strike it down would cause unthinkable harm. We urge the Supreme Court to recognize this damage and keep the law intact.”  

“If the ACA were overturned, it could be devastating for millions of Native Americans around the country. Perhaps most critically it would remove the permanent reauthorization for the Indian Health Care Improvement Act, which provides the legal authority for health care services to over 2.2 American Indians and Alaska Natives across the country,” said Geoffrey D. Strommer, Partner, Hobbs Straus Dean & Walker, LLP. “Native Americans suffer heart disease, diabetes, and cancer more than other populations. And, a recent CDC study noted that Native Americans were 3.5 times more likely to get COVID-19. Without the pre-existing condition protections of the ACA, Native Americans are more vulnerable without these protections. And, finally, overturning the ACA would end Medicaid expansion which has allowed greater access and quality of care to thousands of Native Americans.”  ​

“In Ohio, we are facing new daily record highs of COVID cases and related hospitalizations. Jobs have been lost during this pandemic which means more than ever before, reliance on the Affordable Care Act is necessary to give people the hope of getting good, quality insurance,” said Columbus City Attorney Zach Klein. “It would be irresponsible and cold-hearted to turn our backs on our citizens who need health care during a global pandemic. We are all concerned with the real possibility that the U.S. Supreme Court could strike down the only thing that guarantees access to health care – including for those with pre-existing conditions and the half million Ohioans who now have coverage through the expansion of Medicaid.”

“Hundreds of thousands of Utahns benefit from the Affordable Care Act. With a rapidly surging pandemic and widespread economic hardship, Utahns need the law’s protection now more than ever,” said Matt Slonaker, Executive Director of the Utah Health Policy Project. “Utah Health Policy Project has assisted countless Utahns with accessing sorely needed physical and behavioral health care made possible by the Affordable Care Act. That access has improved countless lives. Efforts to rip that access away are misguided and unfounded.”

“The stakes of this case could not be higher for the nearly 200,000 Nebraskans whose health coverage hangs in the balance,” said Molly McCleery, Health Care Access Program Director, Nebraska Appleseed. “The Affordable Care Act has expanded coverage, implemented vital consumer protections, and has narrowed the systemic inequities in our health care system for Nebraskans and their families. We cannot go backwards.”

“The stakes in this case could not be higher for people with disabilities,” said Jennifer Mathis, Director of Policy and Legal Advocacy at Bazelon Center for Mental Health Law. “Millions of people stand to lose their health care if the Supreme Court dismantles the Affordable Care Act, and for many people with disabilities, this is a life and death matter.”  

“The Affordable Care Act has provided health care coverage for over 400,000 previously uninsured Marylanders,” said Vincent DeMarco, President of the Maryland Citizens’ Health Initiative Education Fund. “We have heard many stories from people whose lives have been saved or made immeasurably better by the ACA. On their behalf, we strongly urge the Supreme Court to keep this life saving law in tact.”

“As the small business community continues to navigate and fully assess the impacts of the COVID-19 pandemic, we must remember that the ACA is vital for entrepreneurs and their employees because it addresses two important issues: healthcare affordability and access,” said John Arensmeyer, Founder & CEO of Small Business Majority. “Indeed, more than 5.7 million small business employees or self-employed workers are enrolled in the ACA marketplaces, and more than half of all ACA marketplace enrollees nationwide are entrepreneurs or small business employees. We strongly urge the U.S. Supreme Court to uphold the ACA in full as it is a necessity for the success of our small business community and our economy.”

“The ACA expanded the community health center program into the single most important source of primary care for millions of low income and medically underserved people,” said Phillip Escoriaza, Senior Counsel at Feldesman Tucker Leifer Fidell LLP. “Health centers are delivering needed primary care services that are critical to the nation’s response to the coronavirus public health emergency. We urge the Court to protect this vital program.” 

“By providing direct funding to community health centers and broadening the scope of covered services, the ACA has dramatically reduced prior gaps in health care delivery—especially in primary care services—and enabled health centers to address more complex patient needs,” said Brendan Tyler, Associate at Feldesman Tucker Leifer Fidell LLP. “As a result of receiving these top quality, highly cost-effective services, health center patients consistently achieve health outcomes that exceed national averages for particular conditions. Repealing the ACA in its entirety would impair the ability of health centers to provide these services.”

Every American could be affected if the ACA is destroyed. In particular, the following is at stake:

  • Healthcare for the 20 million Americans who are able to afford insurance either through Medicaid expansion or thanks to tax credits and employer-sponsored plans through healthcare exchanges, such as Covered California;
  • Guaranteed coverage for the 133 million Americans who have a pre-existing health condition, including 17 million kids, and benefit from the law’s protection against discrimination and higher costs based on health status;
  • Healthcare for young adults under the age of 26 covered by a parent’s plan;
  • Families of children with chronic health conditions who are currently protected from lifetime insurance limits; and
  • Funding for our nation’s public health system, including investments in local and state public health systems that help during the pandemic, FDA biosimilars which power drug costs, and more including Medicare payment reforms, Indian Health Services, and work to fight the opioid epidemic.

Background: In 2018, a Texas-led coalition, supported by the Trump Administration filed Texas v. U.S., arguing that Congress rendered the ACA’s individual mandate unconstitutional when it reduced the penalty to $0 and that the rest of the ACA should be held invalid as a result of that change. California’s coalition defended the ACA in its entirety. The Fifth Circuit held that the individual mandate is unconstitutional, but declined to further rule on the validity of the ACA’s remaining provisions. The court instead sent the case back to the Northern District of Texas to determine which provisions of the 900-page law are still valid. In January, Attorney General Becerra led a coalition in filing a petition to the U.S. Supreme Court seeking review of the Fifth Circuit’s decision. The Supreme Court granted review of California v. Texas in March.

California will fight in court tomorrow on behalf of the attorneys general of Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Massachusetts, Michigan, Minnesota (by and through its Department of Commerce), Nevada, New Jersey, New York, North Carolina, Oregon, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia, as well as the Governor of Kentucky.

A diverse group of bipartisan attorneys general, economists, patient groups, hospitals, healthcare providers, healthcare insurance companies, cities, counties, tribes, and more have expressed support for the coalition’s defense of the ACA and highlighted the importance of safeguarding our public health system.

The Supreme Court will hear oral arguments remotely on Tuesday, November 10, 2020, at 10 a.m. ET / 7 a.m. PT.
Source: CA. DOJ