Ruling in Texas v US could harm Americans’ health, states argue

DES MOINES, IOWA (January 3, 2020) — Iowa Attorney General Tom Miller joined a coalition of 20 states and Washington DC, in asking the US Supreme Court to review the constitutionality of the Affordable Care Act (ACA). 

The states’ petition asks the court to take up the Fifth Circuit Court of Appeals' decision last month in Texas v US and resolve the case before the end of the court’s current term in June. The decision held the ACA’s individual mandate unconstitutional and called into question whether the remaining provisions of the ACA could still stand, including those that protect and provide coverage to Americans with pre-existing conditions.  

“For the last decade, the Affordable Care Act has become an integral part of our health care system,” AG Miller said. “The Fifth Circuit’s decision causes uncertainty that may harm the health of millions of Americans, as well as doctors, clinics, patients, and the health-care market.”  

The lawsuit was originally filed by a Texas-led coalition, and supported by the Trump administration, which argued that Congress rendered the ACA’s individual mandate unconstitutional when it reduced the penalty to $0. They further argued that the rest of the ACA should be held invalid as a result of that change. A coalition led by California defended the ACA in its entirety, supported by a bipartisan group of amici including scholars, economists, public health experts, hospital and provider associations, patient groups, counties, cities, and more.  

Iowa intervened in the case in February 2019 to support the ACA.  

The Fifth Circuit held that the individual mandate is unconstitutional, but declined to further rule on the validity of the ACA’s remaining provisions. The court instead sent the case back to the Northern District of Texas to determine which provisions of the 900-page law are still valid.  

Today’s filing by the coalition states makes clear that patients, doctors, hospitals, employers, states, pharmaceutical companies, and more will be impacted by the looming uncertainty of the Fifth Circuit’s decision. It asks the Supreme Court to review the case this term. It also highlights important advancements in health-care access made under the ACA, including: 

  • More than 12 million Americans receiving coverage through Medicaid expansion;

  • Nearly 9 million individuals nationwide receiving tax-credits to help afford health insurance coverage through individual marketplaces;

  • Millions of working families relying on high-quality employer-sponsored insurance plans;

  • Important protections prohibiting insurers from denying health insurance to the 133 million Americans with pre-existing conditions (like diabetes, cancer, or pregnancy) or from charging individuals higher premiums because of their health status; and

  • Nearly $1.3 trillion in federal funding being dedicated to keeping Americans healthy and covered, including Medicaid expansion and public health dollars.

Joining Attorney General Miller in the filing are the attorneys general of California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Massachusetts, Michigan, Minnesota (by and through its Department of Commerce), Nevada, New Jersey, New York, North Carolina, Oregon, Rhode Island, Vermont, Virginia, and Washington, and the District of Columbia, as well as the governor of Kentucky.

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