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Attorneys general file amicus briefs with Supreme Court for individual mandate

Robin Wulffson MD's picture
Affordable Care Act, ACA, individual mandate, amicus brief, controversy

WASHINGTON, DC - On January 13, Attorneys general from 11 states, the District of Columbia, and the Virgin Islands filed amicus curiae (friend-of-the-court) briefs in regard to the healthcare reform case before the U.S. Supreme Court. The Attorneys general - all Democrats - argue that the requirement for individuals to obtain health insurance coverage falls within the constitution's Commerce Clause, which permits Congress to regulate interstate commerce.

"Congress has that authority," noted Iowa Attorney General Tom Miller at a press conference. "The healthcare industry takes up at least one-sixth of our economy. If anything is interstate commerce, it's healthcare." His filing is one of dozens of amicus briefs inundating the Supreme Court as it prepares to hear oral arguments in late March on the constitutionality of the controversial Affordable Care Act (ACA). Such briefs come not from the actual parties in the suit, such as the officials from 26 states who challenged the law, or the Obama administration, but outside groups with a stake in the case's outcome or expertise on the issues at hand.

There are different deadlines for filing amicus briefs in the ACA case, depending on the particular legal question a group is addressing and what side it is taking. In the matter of the individual mandate to obtain health insurance coverage, proponents of the government's position had until the end of January 13 to get their briefs filed. Other groups or coalitions that have gone on the legal record supporting the individual mandate include: the AARP; the American Cancer Society; the American Cancer Society Cancer Action Network, the American Diabetes Association; the American Heart Association; the American Nurses Association; the American Academy of Pediatrics; the American Medical Student Association; Doctors for America; and the National Hispanic Medical Association

In addition, a number of interest groups have flooded the court with amicus briefs debating whether the entire law should be struck down if the nine judges invalidate the individual mandate. In its filing, the U.S. Chamber of Commerce (COC) supported obliterating the law in that event because so many of its key provisions are related to the individual mandate.

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The COC noted, "Congress understood that simply requiring issuers to provide coverage to all applicants at the same price and under the same terms without regard to their health status would be impractical unless healthy individuals were also required to purchase coverage. Standing alone, these new requirements would lead to less affordable health insurance because significant numbers of healthy individuals would wait to purchase health insurance until they absolutely needed it, forcing issuers to raise premiums for everyone else."

America's Health Insurance Plans, representing private insurers and the Blue Cross Blue Shield Association hold a similar opinion to that of the COC; however, they assert that only portions of the law dealing with insurance reform should be voided if the individual mandate is struck down. The Association of American Physicians and Surgeons (AAPS) is also against severing the individual mandate, which it decries as unconstitutional, from the rest of the law. The AAPS noted that the ACA lacked a severability clause that would have allowed the rest of the law to stand if one provision were struck down. It contended that the Supreme Court has no right to exercise a "line-item veto" of one portion of a law absent such a clause.

Groups that believe the individual mandate cannot be severed from the rest of the ACA had until January 6 to file a brief. The other side has until January 27. Furthermore, amicus deadlines are fast approaching for two other questions the Supreme Court will consider: whether the law's dramatic expansion of Medicaid runs invades states' rights and whether the court is barred from hearing the case until the individual mandate takes effect in 2014 (at which time noncompliant individuals will be forced to pay a penalty).

The 13 Attorneys general who filed the amicus briefs are from California, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Iowa, Maryland, New Mexico, New York, Oregon, Vermont, and the Virgin Islands. As previously mentioned, they all are Democrats. In contrast, of the officials from 26 states who originally challenged the ACA in a federal district court in Pensacola, Florida, all but one are Republicans.

Source: U.S. Supreme Court

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