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 two appeals courts — courts that held different opinions as to whether the federal law is valid — noted how the current situation harms older people's ability to afford and access coverage
AARP's briefs in both the U.S. Court of Appeals for the 11th Circuit (which struck down the law) and the 4th Circuit (which dismissed the various challenges) provided information explaining how the law was created as a measured response to a national crisis.
The attorneys general of the states of Florida and Virginia, in separate lawsuits, challenged the ACA, arguing that Congress unconstitutionally exceeded its authority.
AARP's "friend of the court" briefs in the two federal appeals courts argued 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 .
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 and for whom an unanticipated expense poses particular problems.
AARP's briefs, submitted by AARP Foundation Litigation attorneys, pointed out that older people without employer-provided health insurance who do not qualify for Medicaid and do not yet qualify for Medicare are systematically denied coverage or priced out of the private market because of their age or pre-existing health conditions. Citing studies documenting how uninsured and underinsured people suffer worse health outcomes and require more intensive and costlier care when they enter Medicare, the briefs noted that the ACA provides a measured and effective response to these problems.
Florida's challenge was successful; Virginia's was not. The debate most likely now shifts to the U.S. Supreme Court, where all of the parties have filed petitions seeking the Court's review.
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.
State of Florida, ex rel. Bondi v. U.S. Department of Health and Human Services and Commonwealth of Virginia, ex rel. Cuccinelli v. Sebelius were decided by the U.S. Courts of Appeal for the 11th and 4th circuits, respectively. The 6th Circuit has upheld the law, the 3rd Circuit dismissed a challenge, and suits are pending in 5th, 8th, 9th, and D.C. circuits. The split in circuits indicates a Supreme Court review is likely.