Affordable Care Act Challenge in Texas

June 17, 2021

The American Cancer Society, American Cancer Society Cancer Action Network and public health partner organizations celebrated a tremendous victory when the Supreme Court of the United States (SCOTUS) ruled in a 7-2 decision to uphold the Patient Protection and Affordable Care Act (ACA).  Read our statement. 

ACS CAN led 18 other groups in filing an amicus curiae, or “friend of the court,” brief defending the law. The brief provided the high court with extensive scientific evidence proving the link between health insurance coverage and medical outcomes, citing the devastating effects on patients would face should the law be overturned.

The brief was filed as a result of a decision by the US Court of Appeals for the Fifth Circuit that the provision of the law requiring individuals to purchase health insurance (the “individual mandate”) is unconstitutional.  The Fifth Circuit then remanded the case back down to the trial court to determine which provisions of the law can be severed from the mandate, and which can stay in place.  However, states defending the law urged the high court to take up the case immediately to prevent consumer uncertainty and market instability.  ACS and ACS CAN filed an amicus brief supporting that petition.  Fortunately, the ACA stays in effect until the case is decided in full.

ACS, ACS CAN and 15 other health groups had also filed an amicus curiae brief at the Fifth Circuit in April of 2019.  That brief provided the court with similar data on the link between insurance coverage and health outcomes.

By way of background, twenty states, led by the attorney general of Texas, filed a lawsuit challenging the ACA in federal court in Texas. The plaintiffs in Texas vs. US argue that because Congress repealed the individual mandate's tax penalty as part of tax reform legislation in December 2017, the entire law is invalid and must now be struck down.  In December of 2018, District Court Judge Reed O’Connor ruled in favor of the plaintiffs, striking down the entire law.  

Texas vs. US threatens vital patient provisions that ACS CAN fought to include and protect, including those that prohibit pre-existing condition exclusions by insurance companies and prohibit insurers to deny coverage and charge more for certain individuals based on health status. These patient protections are not only improving access to meaningful health care for many cancer patients and survivors, but they are also key to achieving the American Cancer Society’s lifesaving mission. It is important that courts are aware of the real impact their decisions could have on a patient’s ability to access health insurance that covers critical cancer prevention, early detection, and treatment services.

As the representative of the administration, the U.S. Department of Justice (DOJ) typically defends the law of the land. However, in a disturbing development, DOJ has not defended the health care law and instead supports the plaintiffs in the case arguing to overturn it. The DOJ position makes it even more important for ACS and ACS CAN to underscore the implications the litigation could have on patients.