Repeal of Affordable Care Act Would Devastate Health Care for Millions of Americans and Worsen COVID-19 Pandemic, Says Public Health Amicus Brief

Date: May 13 2020

Contact:  APHA Media Relations, 202-777-3913
For GWU: Kathy Fackleman, 202-994-8354; Mina Radman, 202-486-2529

Washington, D.C., May 13, 2020  – The Affordable Care Act has been essential to American public health over the past decade and its loss in the midst of a global pandemic would be a calamity, according to an amicus brief filed in the United States Supreme Court. The brief is signed by the American Public Health Association, American Academy of Nursing, and more than 220 deans, department chairs, and scholars from 54 schools of public health, public policy, nursing and medicine.

In the amicus brief, the scholars show that the Affordable Care Act has laid a strong foundation for national public health initiatives, providing millions of Americans with access to health care and health insurance. Thanks to the Affordable Care Act, more than 90 percent of Americans now have some form of health insurance. In the midst of the COVID-19 pandemic, the scholars argue that this coverage is crucially important and has provided the foundation for the national response to COVID-19. Building on the law, Congress has ensured that public and private health insurance plans must cover COVID-19 testing without cost-sharing, a reform that is critical to testing and treatment, since Americans are more likely to seek health care if insured.

The brief was filed ahead of arguments that the Supreme Court will hear this fall in California et al. v Texas et al. The Supreme Court will decide whether the Affordable Care Act’s “individual mandate” remains constitutional after the U.S. Congress removed the tax penalty for those who do not maintain health insurance. The Supreme Court also will decide whether, if the individual mandate is deemed unconstitutional, the entire law must be repealed.

“The Affordable Care Act has become crucial to the health care system,” said Lynn R. Goldman, MD, MS, MPH, the Michael and Lori Milken Dean of the George Washington University Milken Institute School of Public Health (Milken Institute SPH) and one of the amici who signed the brief. “A decision to strike down the entire law would have massive disastrous effects, not only throughout the health care system, but for public health and the broader national economy.”

In the brief, the amici argue that if the individual mandate is found unconstitutional, it should be severed from the rest of the law instead of repealing the Affordable Care Act in its entirety.

If the entire law were repealed, the scholars explain, millions of Americans would completely lose health insurance under private health plans, Medicaid and Medicare. Health insurers would again be able to deny coverage to people with preexisting health conditions, charge higher rates to the sick, and impose annual and lifetime caps on coverage. The amici argue, furthermore, that the cost of prescription drugs for the elderly would rise, millions of people would lose access to community health centers, and the law’s landmark Prevention and Public Health Fund would be eliminated.

“Repeal of the Affordable Care Act would be deeply damaging to the American healthcare system and public health. It would reverse years of lives saved and diseases avoided due to its coverage and insurance protections. Its loss would add to the devastation in the public’s health we are already seeing from the COVID-19 pandemic and would remove health insurance protections right when we need them the most,” said APHA Executive Director Georges Benjamin, MD. “With millions of jobs already lost and insurance coverage evaporating for many due to the worst economic downturn since the Great Depression, we should be expanding not reducing health insurance coverage for our population. In addition, repeal of the law would remove the Prevention and Public Health Fund, an essential source of funding for the nation’s public health system. This fund is more important than ever, as we look to address a range of health threats that continue to undermine the health of Americans.”

The brief was filed in the U.S. Supreme Court on May 13. The deans, chairs, and scholars; American Public Health Association, representing 25,000 public health professionals; and American Academy of Nursing, representing 20,000 nursing professionals, were represented by H. Guy Collier, Michael B. Kimberly, and Matthew A. Waring of McDermott Will & Emery LLP of Washington, D.C.

The public health scholars who signed the brief did so in their individual capacities. The views expressed are their own and do not represent the scholars’ affiliated universities.

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The American Public Health Association champions the health of all people and all communities. We are the only organization that combines a nearly 150-year perspective, a broad-based member community and the ability to influence federal policy to improve the public’s health. Learn more at www.apha.org.