AARP Foundation Litigation attorneys filed AARP's three friend of the court briefs in the Supreme Court. The first brief addressing the minimum coverage provision argued that the ACA was constitutional under Congress's Commerce Clause and Taxing powers. The brief provided the Court with massive evidence showing that people 50-64 without employer-provided or government health insurance are systematically denied coverage or priced out of the private individual market because of their age or pre-existing health conditions; describing the effect on the national economy and on public health by millions of un- and underinsured people who cannot afford medical diagnosis and treatment and go into debt or bankruptcy; and the "job lock" preventing people from retiring or changing jobs because they cannot obtain or afford health insurance on the private market for them or family members.
In the second brief, AARP joined with 39 organizations in filing a brief explaining how (1) state participation in Medicaid is and always has been voluntary; (2) starting in 2014, states will receive near total funding for the expansion; and (3) the expansion in ACA is consistent with the history and structure of the Medicaid program and other numerous changes to the program since its inception.
In a third brief addressing the severability issue, AARP joined with several other national organizations that advocate for older people. The brief provided the court with a description of the many provisions in the ACA that are vitally important to older people yet unrelated to the minimum coverage provision, such as improvements to Medicare benefits and prevention of elder abuse.
What's at Stake
What the decision means for people who have private or employer-based insurance is that insurance companies can no longer drop coverage if the person becomes sick or disabled or place lifetime dollar limits on health coverage, and plans must now cover more preventive care services (such as mammograms and other screenings) at no additional cost.
People who do not have insurance or have preexisting conditions limiting their ability to acquire services get relief as well - many adults and all children up to age 19 with a preexisting condition can no longer be denied coverage (a protection that will expand in 2014 to cover all persons with preexisting health conditions), and children up to age 26 can now be covered under a parent's health insurance plan.
States that decline to expand Medicaid eligibility for low-income citizens within its state will not receive the federal government's offer to provide 100 percent funding to cover the expansion for the first three years and 90 percent thereafter. If a state does not expand coverage, many low-income people will not be able to obtain health insurance. Those individuals will not be responsible for paying the optional tax for not having insurance starting in 2014. In addition, many of those affected will be eligible for subsidies to help pay for insurance through their state exchange beginning in January 2014.
Finally there are benefits for Medicare beneficiaries, including expanded coverage of wellness visits and preventive care services, discounts on prescription drugs for those harmed by the "doughnut hole" that inadvertently left some recipients without coverage, and there are new strong tools to fight waste, fraud and abuse in the Medicare program as well as strengthen its solvency.
The U.S. Supreme Court held the Patient Protection and Affordable Care Act constitutional in the cases Florida v. HHS, HHS v. Florida, and NFIB v. Sebelius.