AMA Filing Amicus Brief to Protect Coverage and Insurance Reforms

The following remarks were presented to the House of Delegates at the AMA’s Annual Meeting during Tuesday’s business session by Dr. Gerald E. Harmon, Chair, AMA Board of Trustees.

The AMA, joined by specialty societies, will file an amicus brief in the case of Texas vs. the United States to oppose a lawsuit that seeks a result contrary to longstanding AMA policy and advocacy to expand coverage and implement key health reforms.  If the plaintiffs in the suit are successful, the following provisions of the Affordable Care Act would be null and void:

  • Patients would no longer would have protections for pre-existing conditions
  • Children would no longer have coverage under their parents’ health insurance plan until age 26
  • Insurers would no longer be held to the 85% medical loss ratio, meaning they could generate higher profits at the expense of coverage and payments for services
  • 100 percent coverage for certain preventive services would cease
  • Annual and life-time dollar limits could be reinstated, leading to more bankruptcies due to health care costs

Each of these provisions has broad, bipartisan and public support.

The lawsuit seeks to change the federal government’s health policy through the courts, rather than through the legislature, which would violate the principle of separation of powers.  If the plaintiffs were successful, federal policy would roll back to 2009 without any substitute in place. This suit adds further disruption to an insurance market that has been harmed by premium increases and political battles that undermine coverage and enrollment.

At the time of its passage and ever since then, the AMA has acknowledged that the ACA has flaws and policymakers need to fix problems, gaps and unintended consequences of this law. The association continues to press for action to stabilize the individual market and recently achieved repeal of the Independent Payment Advisory Board after several years of AMA and Federation advocacy.

With health insurance coverage having already eroded this year, an unfavorable decision at the district court level would cause further disruption, uncertainty, spark additional premium increases and cause further declines in coverage.

Separate amicus briefs aligned with the AMA’s position have or will be filed by hospital, insurer and patient groups.  The AMA’s amicus brief continues its long-time advocacy to achieve coverage for the uninsured as well as insurance market reforms important to patients and physicians.

In response to this announcement by Dr. Harmon, representatives of the Texas Medical Association, which supported the suit filed by the state of Texas challenging the constitutionality of the Affordable Care Act (ACA), publicly objected to the AMA’s plans to file the amicus brief.

“We fervently urge the AMA not to file a brief in this case at this time,” David Henkes, MD, chair of the Texas Delegation to the AMA House of Delegates said on the floor of the house. “The ACA is an extremely unpopular political symbol in our state. Should the AMA file a brief in this case, I have no doubt it will interfere with our work on key state issues such as liability reform, scope of practice, insurance reform, Medicaid, public health and graduate medical education.”


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