Ohio, Montana attorneys general join industry groups in urging appeals court to uphold ACA

Affordable Care Act
Healthcare organizations—and two Republican attorneys general—want a federal appeals court to protect the Affordable Care Act. (Getty/zimmytws)

Following the Trump administration’s support last week of a judge’s ruling invalidating the Affordable Care Act, healthcare organizations—and two Republican attorneys general—are calling on the courts to protect the law. 

In a brief (PDF) filed Monday, Ohio Attorney General Dave Yost and Montana Attorney General Timothy Fox argue that the ACA's individual mandate, which was repealed by Congress, can be removed from the law without rendering the other provisions unconstitutional. 

Yost said in a statement that if the entire ACA were rendered invalid, it would leave 1.9 million Ohio residents with pre-existing conditions without coverage. 


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“I do not like judicial activism in either its liberal or conservative flavors,” Yost said. “Chief Justice Marshall was right when he said it is the province of the courts to say what the law is—but it is also true that the writing of the law belongs to Congress.” 

RELATED: Kentucky, West Virginia among states that would be hit hardest by an ACA rollback 

The Department of Justice filed a letter last week in which it said the Fifth Circuit appeals court should uphold a district court judge’s decision that struck down the ACA in its entirety based on the individual mandate repeal. 

Judge Reed O’Conner’s decision was roundly criticized by the healthcare industry, and several groups weighed in on the appeal with briefs of their own in response to the DOJ’s letter.  

America’s Health Insurance Plans (AHIP) said (PDF) the ruling “disregards that manifest congressional intent and ignores the devastating consequences that would ensue” if the ACA is rolled back. 

It noted that, under the ACA, 20 million additional people were insured, and health insurers have invested significant resources—both time and money—in adjusting to the law’s exhaustive reforms. 

“Invalidation of the ACA—irrespective of the continued operation of the so-called individual mandate—would thus wreak havoc on the health care system,” AHIP wrote in the brief. 

RELATED: DOJ injects further uncertainty into ACA markets—but for some it’s just more legal ‘noise’ 

The American Medical Association alongside a number of other physician groups echoed (PDF) AHIP, saying that the majority of reforms in the ACA—especially those directly impacting doctors—are unrelated to the individual mandate. 

This includes value-based care models and care quality reforms that have no direct link to insurance policy, and thus the courts have no power to strike them down, the letter said. 

“At the very least, the district court’s deficient severability analysis requires a remand for a proper analysis,” the groups wrote. 

The American Hospital Association, America’s Essential Hospitals, the Federation of American Hospitals and the Association of American Medical Colleges filed a similar brief (PDF) challenging the ruling. 

O’Connor’s ruling is based on a “premise finds no support in law, logic, or experience,” the hospital groups said. 

“If left in place, the district court’s wholesale judicial repeal of the ACA will have disturbing consequences,” they said. “It would drag this country back into the world before the ACA, removing millions from the insurance rolls—and without coverage, Americans suffer.” 

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