Disability groups argue in support of the individual mandate

Fourteen leading disability and health organizations filed an amicus brief to the Supreme Court on January 12, defending the Affordable Care Act’s individual mandate requiring every individual nationwide to obtain health insurance coverage as an appropriate use of Congressional authority.

This is a photograph of the front of the U.S. Supreme Court Building.
U.S. Supreme Court Building

The groups argue that the individual mandate is necessary for the implementation of the health care bill’s provision barring insurance companies from discriminating against people with pre-existing conditions.

“Congress appropriately considered the minimum coverage provision necessary and essential to address the shifting of costs by uninsured individuals seeking medical care to other participants in the system – providers, the government (taxpayers), and insured individuals and families (through higher premiums),” the groups stated. “Individuals who do not carry insurance are nonetheless participants in the health care market and, collectively, shift billions of dollars of costs onto third parties.

“These adverse impacts are especially acute because federal and state laws, as well as widespread practices and customs, require hospitals to provide treatment to uninsured   individuals whether they can pay their bills or not. Correcting these widespread and severe market failures unique to the national health insurance and services sector provides ample justification for the minimum coverage provision”

The brief analyzes seven states with the pre-existing conditions provision but no individual mandate, concluding that they are a “failed experiment” that suffer from “sky-rocketing insurance premium costs, reductions in individuals with coverage, and reductions in insurance products and providers.”

In contrast, Massachusetts citizens have seen a 40 percent reduction in their premiums since then-governor, and Republican presidential candidate, Mitt Romney signed the state’s individual mandate into law in 2006, to accompany its preexisting conditions provision.

“An unbroken pattern shows that pre-existing conditions provisions, absent a minimum coverage provision, are a failed experiment,” the groups stated in the amicus brief. “At best, they result in premium increases. At worst, they cause the total collapse of a state‘s individual insurance market.”

Opponents of the individual mandate contend that its an overreach of federal power that relies on an broad reading of Congress’ authority to regulate interstate commerce under the 10th Amendment.

The disability and health groups criticize the reasoning used to strike down the mandate by the U.S. Court of Appeals for the 11th Circuit, the decision picked by the Supreme Court for review and the lone decision, of the four appellate courts whom have reviewed the individual mandate, to rule against the Obama Administration.

The groups contend that the 11th Circuit, in its extensive analysis of the individual mandate’s effectiveness, applied a stricter level of review than what courts typically use when determining whether to uphold economic legislation enacted by Congress.

Citing language used by the Supreme Court in a 2005 decision based on similar questions regarding Congress’ power to regulate interstate commerce, the groups argue that a decision striking down the individual mandate would fundamentally change the Court’s long-held deference to Congress in economic matters.

In the 2005 case, the Supreme Court, referring to when the court should step into prevent Congressional overreach in economic decisions, stated that the “The Court, must sustain the law as long as ‘Congress had a rational basis for believing that failure to regulate…would leave a gaping hole (in an economic regulation scheme).”

The organizations listed on the brief includes The ARC of the United States, the American Association of People with Disabilities, and the National Health Law Program.

An estimated 57.2 million Americans under the age of 65 have preexisting conditions. According to a Congressional investigation cited in the amicus brief, the nation’s four largest for-profit health insurance providers reject one in every seven applicants based on their preexisting conditions.