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Court of Appeals Refuses to Review Challenges to Health Care Reform Law

The Patient Protection and Affordable Care Act (ACA), enacted in 2010 by Congress after fierce debate, has been challenged by several states, organizations and individuals. AARP's briefs in several of these disputes provide information explaining how the law was a measured response to a national crisis.

Courts have come to different conclusions regarding various provisions of the law, and the ultimate resolution will be in the U.S. Supreme Court. In the meantime, in one of the cases in which AARP filed a brief, the Fourth Circuit Court of Appeals refused to consider challenges the law.


The attorney general of Virginia challenged the ACA, arguing that Congress unconstitutionally exceeded its authority. AARP filed a "friend of the court" brief in opposition to that position. On the same day that the U.S. Court of Appeals for the Fourth Circuit rejected the Virginia attorney general's arguments, finding that the State lacked standing to sue, the court also ruled in a separate case (Liberty University v. Geithner) that a challenge to the law was premature as the challenged provision has not yet taken effect.

When the ACA was enacted in March 2010, 45 million Americans did not have health insurance, primarily because they could not afford it, and health care costs were outpacing the rate of inflation. Congress recognized that people were falling into financial ruin or foregoing critical medical care (or both) when faced with health care needs they could not afford to address.

AARP's brief, filed by attorneys with AARP Foundation Litigation, point out that older people without employer-provided health insurance who do not qualify for Medicaid and do not qualify for Medicare are systematically denied coverage or priced out of the private market because of their age or pre-existing conditions. Citing studies documenting how uninsured and underinsured people suffer worse health outcomes, require more intensive and costlier care when they enter Medicare, the brief notes that the ACA provides a measured and effective response to these problems. AARP's brief argues that Congress not only has the authority to enact this law, but that the law is a carefully tailored and measured response to a growing crisis affecting interstate commerce, state and federal budgets, and the health and well-being of millions of Americans

What's at Stake

People ages 50 to 64 that need to buy health insurance on the private market have been especially harmed by current health insurance industry underwriting practices. That population needs more health services and is more likely to suffer from chronic health conditions than younger counterparts, yet that segment of the population faces extreme obstacles in the private market because of industrywide insurance underwriting and rating practices that discriminate based on health status and age.

Case Status

Virginia filed a petition for certiorari in the U.S. Supreme Court from the U.S. Court of Appeals for the Fourth Circuit's decision in Virginia v. Sebelius. The Supreme Court is holding the petition and the other cert petitions pending from the ACA cases until it decides Florida v. HHS. Oral argument is scheduled for March 26-28, 2012.

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