The Affordable Care Act has been essential to U.S. public health over the past decade, and its loss during a pandemic would be a disaster, APHA told the Supreme Court in a friend-of-the-court brief filed May 13. The brief was submitted by APHA, the American Academy of Nursing and more than 220 deans, department chairs and scholars from 54 schools of public health, public policy, nursing and medicine.

The Supreme Court will hear arguments this fall in California et al. v. Texas et al to decide whether the Affordable Care Act’s individual mandate, which required people to have health insurance or pay a fine, remains constitutional. In 2017, Congress passed legislation removing the penalty, which took effect last year.

Most crucially, the Supreme Court also will decide whether the ACA is constitutional without the individual mandate. Repeal of the law “would be deeply damaging to the American health care system and public health,” according to Georges Benjamin, MD, APHA’s executive director.

 “Its loss would add to the devastation in the public’s health that we are already seeing from the COVID-19 pandemic and would remove health insurance protections right when we need them the most,” Benjamin said in a news release.

If the individual mandate is ruled to be unconstitutional, it should be severed from the rest of the law instead of repealing the Affordable Care Act in its entirety, APHA and the other supporters said in the brief. If the act is repealed: 

  • Millions of Americans will lose health insurance under private health plans, Medicaid and Medicare; 
  • health insurers will again be able to deny coverage to people with pre-existing health conditions, charge higher rates to the sick and impose annual and lifetime caps on coverage; 
  • the cost of prescription drugs for older adults will rise; 
  • millions of people will lose access to community health centers; and 
  • the law’s landmark Prevention and Public Health Fund — an essential source of funding for the nation’s public health system — would be eliminated.  

To show your support for the ACA, share the news release on social media.