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Thursday, January 29, 2015

11 Diverse Organizations Filing Amicus Briefs Supporting the ACA in King v. Burwell

Today we kick off a weekly series—one that analyzes the political, legal, and social issues and ramifications of King v Burwell, a lawsuit before the Supreme Court that challenges the Affordable Care Act’s (ACA) provision of tax credits to help consumers buy health insurance in states where the federal government runs the marketplace. We start off our series with a quick look at some of the individuals and groups who have filed “friend-of-the-court” (amicus) briefs, urging the Court to rule against the plaintiffs in the case.

Yesterday, a large group of organizations and individuals filed amicus briefs in King v Burwell. If the Court sides with the plaintiffs, the government would strip away tax credits from several million low- to moderate- income people in more than three dozen states, jeopardizing their ability to pay for—and thus access—health coverage. This is a grave threat to the Affordable Care Act, and the chief reason why so many groups and individuals are opposing the lawsuit. 

Families USA filed its own amicus brief—one that argues that the law intended that “affordable health coverage was to be provided to legal residents in all states, irrespective of whether a state runs the marketplace directly or whether the federal government is facilitating it for the state.”

The Affordable Care Act intended that “affordable health coverage was to be provided to legal residents in all states, irrespective of whether a state runs the marketplace directly or whether the federal government is facilitating it for the state.”–Families USA’s Amicus brief to the Supreme Court for King v Burwell

Who filed amicus briefs in King v Burwell:

At least 11 groups representing a diverse set of stakeholders filed briefs also expressing the shared belief that Congress always intended to bring affordable health insurance to people in every state—and that the language of the ACA reflects that intent. (There were more than two dozen groups who filed briefs.) 

The wide spectrum of those who filed briefs proves the enormity of support for the Affordable Care Act’s health insurance in general, and the continued availability of financial help for consumers (premium tax credits) in particular. Here’s a quick look at some of the individuals and groups who filed, along with the constituencies who would suffer if the Supreme Court rules in favor of withdrawing premium tax credits in states with federally facilitated marketplaces. 

  • Members of Congress who wrote the ACA – While not personally adversely affected by an adverse ruling, the members of Congress who authored the law and chaired the key health committees in 2010 argued that they always intended for tax credits to be available in all states—a key argument for the Court to consider in its ruling.
  • Consumers with serious and life-threatening health problems – In an attempt to share with the Court how their health—and their lives—are at stake, consumers with serious health conditions and who receive premium tax credits from states with federally run marketplaces told their very personal stories.
  • Nearly half of the states – Twenty-two states and the District of Columbia (including states, such as Mississippi and New Hampshire, that have traditionally opposed the ACA) argued that Congress never informed states that they might be denied tax credits if they didn’t set up state-run health insurance exchanges, and emphasized the potential harm their residents would face if tax credits were withdrawn. 
  • Women - Women’s organizations, led by the National Women’s Law Center, described how important premium tax credits are for ensuring that women, who traditionally have had trouble accessing health insurance, can get the health care they need. 
  • Patients with chronic diseases – Organizations representing patients with cancer, diabetes, heart disease, and multiple sclerosis explained that being uninsured puts these patients at both financial and medical risk
  • Community health centers – Primary care associations representing hundreds of federally qualified health centers pointed out how tax credits allow them to treat more people in need of health care.
  • People living with HIV/AIDS – Groups and individuals from around the country that represent those living with HIV/AIDS describe how the ACA’s premium tax credits allow individuals to live—and not die—from the disease
  • Health insurance companies - America’s Health Insurance Plans, the trade association for the health insurance industry, described how an unfavorable court decision would destabilize the health insurance market and raise premiums across the board for all enrollees. 
  • Hospitals – The American Hospital Association, the Hospital Association of America, and the Catholic Health Association (which represents Catholic hospitals) each filed a brief explaining how the elimination of premium tax credits would devastate hospitals’ abilities to serve the poorest Americans.
  • Children – According to a group of children’s advocacy groups and doctors, if the Court rules unfavorably, a different section of the Affordable Care Act—one that addresses access to the Children’s Health Insurance Program (CHIP)—is also put at risk
  • Small Businesses – Groups representing small business owners tell the Court that tax credits encourage Americans to take the risk of starting their own business.

Oral arguments in King v. Burwell are scheduled for March 4, 2015. 

The stakes are high. In only its second year of implementation, several million people have bought health coverage through the ACA marketplaces run by the federal government. In the coming weeks, we will be sharing stories of some of these people to illustrate how much they stand to lose if the government loses in King v. Burwell. Visit to learn more.