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 brief in the lawsuit brought by the Virginia Attorney General provides the Court with critical information explaining how the law was a measured response to a national crisis.
The Attorney General of the Commonwealth of Virginia, Kenneth Cuccinelli, challenged the ACA, arguing that Congress exceeded its authority and imposed requirements in violation of the U.S. Constitution.
AARP's "friend of the court" brief, filed by AARP Foundation Litigation attorneys, 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 wellbeing of millions of Americans .
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. The problem is particularly acute among older people, who have a higher incidence of chronic health conditions and also more often find themselves on fixed or limited incomes (i.e., retirees or those nearing retirement age), and for whom an unanticipated expense poses particular problems.
AARP's brief points out that older people who do not have employer-provided health insurance, do not qualify for Medicaid, and do not yet qualify for Medicare are systematically denied coverage or are priced out of the private market because of their age or pre-existing conditions. The brief cites numerous studies that document how uninsured and underinsured people suffer worse health outcomes, requiring more intensive and costlier care when they enter Medicare, putting a tremendous burden on the Medicare program. The brief also notes that peoples' worries about losing employer-provided health insurance restricts their ability to move among jobs ("job lock"), thus impeding interstate commerce. Finally, the brief notes that the ACA provides a measured and effective response to these problems.
What's at Stake
People age 50-64, who 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 industry-wide insurance underwriting and rating practices that discriminate based on health status and age.
Commonwealth of Virginia, ex rel. Cuccinelli v. Sebelius is before the U.S. Court of Appeals for the Fourth Circuit. Oral argument is scheduled for May 10, 2011.