Nessel joins coalition of 20 states and District of Columbia defending the ACA in U.S. Supreme Court

Michigan Attorney General Dana Nessel Thursday joined a coalition of jurisdictions in filing a brief in the U.S. Supreme Court to defend the Affordable Care Act (ACA) against efforts by the Trump administration and the state of Texas to repeal the entire ACA, putting the health care of tens of millions of Americans at risk.

The Supreme Court agreed to review a recent Fifth Circuit Court decision that held the ACA’s individual mandate unconstitutional and called into question whether the remaining provisions of the law could still stand – jeopardizing Medicaid expansion, critical public health programs that help fight coronavirus disease 2019 (COVID-19), and subsidies that help working families access care, among countless others. Critically, this decision threatens health care coverage protections for 133 million Americans with pre-existing conditions, and would allow health insurance companies to deny individuals care or charge more based on their health status.

“Millions of Americans concerned about their well-being are provided with resources they need through the Affordable Care Act, but the ACA is under attack,” Nessel said. “This action to toss out the ACA without a realistic substitute is putting the health of our country and its residents in jeopardy. The Affordable Care Act has advanced health care initiatives for millions of working-class families and individuals with pre-existing conditions, and my colleagues and I urge the Supreme Court to consider the public’s best interest as it reviews the Fifth Circuit’s decision.”

The lawsuit, originally filed by a Texas-led coalition, and later supported by the Trump administration, argued that Congress rendered the ACA’s individual mandate unconstitutional when it reduced the penalty for forgoing coverage to $0. They further argued that the rest of the ACA should be held invalid as a result of that change.

While the Fifth Circuit held that the individual mandate is unconstitutional, it did not address the validity of the ACA’s remaining provisions during its December 2019 ruling.

If the ACA is struck down, coverage for millions of Michigan residents may be stripped away including: 

• Protections for 4,103,600 Michiganders with pre-existing conditions might end;

• 720,000 Michiganders could lose their coverage, causing a 115% increase in the uninsured rate;

• Medicaid expansion would be repealed, meaning the 688,300 Michiganders who are covered through Medicaid expansion may lose
coverage;

• 73,000 young adults will no longer be able to stay on their parents’ coverage;

• Protections for women, who were previously charged 50% more than men by insurance companies, may disappear;

• Key support for rural hospitals could vanish, leaving Michigan hospitals on the hook for $1.9 billion more in uncompensated care costs;

• 4,543,547 Michiganders could once again have to pay for preventive care, like mammograms and flu shots; and

• Insurers will no longer have to cover a set of essential health benefits, including hospitalization, prescription drugs, or mental health services.

In January, Attorney General Nessel joined the coalition in petitioning the Supreme Court for review in order to protect Americans’ health care and resolve the uncertainty created by the Fifth Circuit decision. The Supreme Court in March agreed to review the lower court’s ruling.

In the filing, the coalition makes clear that patients, doctors, hospitals, employers, workers, states, pharmaceutical companies and more will be negatively impacted if the ACA should fall. The brief also highlights important advancements in health care access made nationally 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.