News

By Elizabeth G. Taylor, Executive Director of the National Health Law Program, Juliet Choi, President and CEO of the Asian & Pacific Islander American Health Forum (APIAHF), and Leslie Dach, Chair of Protect Our Care

Last week, Arkansas released updated Medicaid enrollment data that serves as a dire warning for the rest of the nation: 72,802 people who rely on Medicaid lost their insurance coverage in April — 40 percent of whom were infants or children. About 80 percent of Arkansans who lost coverage were disenrolled from Medicaid because they did not meet Arkansas’ paperwork requirements like completing renewal forms properly, not because of a determination that they no longer qualify for Medicaid.

This comes as Republicans in Washington passed legislation to impose even more paperwork requirements in Medicaid nationwide — threatening coverage for 21 million people. The devastating outcomes of both these initiatives are by design and reflect a broader national trend: Republicans are using bureaucracy and paperwork to kick people off their health care coverage. 

Congress passed bipartisan legislation at the beginning of the COVID-19 pandemic to protect access to Medicaid by ensuring no one could be disenrolled during the public health emergency. This provision expired on April 1, 2023, and an estimated 15 million people nationwide – including millions of people of color – are at risk of losing coverage as states begin the massive task of determining who on their Medicaid rolls remains eligible. Every state is working to re-evaluate their Medicaid rolls and has a year to do so, but Republican-led states like Arkansas are moving at breakneck speed to throw people off of coverage.

Republicans in Congress continue to impose barriers to coverage for millions of Americans, including by passing partisan legislation in the House of Representatives, jeopardizing Medicaid coverage for an estimated 21 million people by imposing additional work reporting requirements. Introducing more red tape for beneficiaries as states are already overwhelmed with the unprecedented and complex redetermination process would be nothing short of disastrous. 

By seeking to impose work requirements nationwide, House Republicans want to export Arkansans’ misery to the rest of America. In 2018, when Arkansas implemented a less extreme version of work reporting requirements, over 18,000 people (or one in four subject to these requirements) lost their coverage in just seven months; adding red tape quickly takes health care away from people who rely on it. And since two-thirds of families who count on Medicaid include people who already work and the vast majority of others are caregivers, students, or physically unable to work, it’s clear that work reporting requirements are about reducing Medicaid enrollment, not about promoting work.

As representatives of leading civil rights, health equity, and health care organizations, we strongly oppose any barriers to accessing health care. Throwing people off their Medicaid will exacerbate racial and ethnic disparities in access to care. People of color make up a greater portion of those on Medicaid  — a direct result of deep-rooted historical discrimination in employment, housing and education, as well as other forms of structural racism. While people of color make up 35% of Arkansans under age 65, they comprise 44% of people who count on Medicaid. The same is true of nutrition assistance and income support programs like SNAP and TANF. We are deeply concerned with proposals to take nutrition support away from households if they are not able to navigate a complex bureaucratic system to document they are working or prove they are exempt. 

Public officials in states across the country have an obligation to minimize coverage losses as the redetermination process continues rather than pursuing new, harmful proposals. Lawmakers in Washington should reject Speakers McCarthy’s default bill and its burdensome work reporting requirements. No one should lose their health care coverage, nutrition assistance or income support due to paperwork or red tape. Medicaid is proven to save lives, help people from all backgrounds stay healthy, keep rural hospitals and other safety net providers open, boost local economies, and support needed preventive care. It must be protected and strengthened, not gutted through an anti-working poor agenda.

FOR IMMEDIATE RELEASE
Monday, May 22, 2023
Contact: Jack Cardinal, (781) 960-5208, [email protected]
Anne Shoup, [email protected]

Campaign Launches With Full Page New York Times Ad
And Weeklong Digital Ad Campaign

Washington, DC — Community Catalyst Action Fund and Protect Our Care are launching an ad campaign ahead of a day of action tomorrow to oppose any cuts to Medicaid and SNAP in a final deal on the Republican’s debt default plan. The effort is backed by dozens of other leading health justice organizations, and patient and provider advocate groups. 

The ad campaign kicked off with a joint ad in The New York Times and a weeklong digital ad campaign from Community Catalyst Action Fund. 

You can see the joint NYT ad here, which reads: The Republican default plan could take health care and food support away from millions of people and families. Tell them: No cuts to Medicaid or SNAP. 

The digital ads from Community Catalyst Action Fund will run throughout the week and target key lawmakers.

The day of action is an opportunity for local, state and community partners and advocates to engage policymakers in a discussion about the impact that these cuts would have on people and families in their communities, many of whom are already struggling to make ends meet. It is also a moment to remind policymakers that Medicaid is also one of the best ways to prevent medical debt, which impacts more than 40 percent of households and will only worsen if Congress continues to give tax breaks to the wealthy while cutting key programs for families and people with low incomes. Due to racism and other forms of oppression, cuts to Medicaid deepen health inequity of already systematically excluded communities, which is why there is Tri-Caucus led effort to speak out against these proposals.

“It is shameful and wrong that some are willing to hold our economy hostage to advance an agenda of taking affordable health care and food away from millions of people,” said Emily Stewart, executive director of Community Catalyst and Community Catalyst Action Fund. “Our message to Congress is clear: No cuts to Medicaid, SNAP or TANF. It is unconscionable to take away health care and food away from those who need it while protecting tax cuts for the wealthy and massive corporations.”

“Republicans are threatening to default on our nation’s debt in order to push their radical agenda of ripping away health care and other vital support from millions of Americans,” said Protect Our Care Chair Leslie Dach. “They have fully reginited their war on health care and food assistance, fighting to slash programs that keep families, people with disabilities, parents and caregivers healthy, at work and out of poverty in order to protect tax breaks for the wealthiest people and corporations. People across political parties, no matter where they live, overwhelmingly oppose this MAGA agenda and are raising their voices in opposition.”

Sherrell Bird knows all too well the impact that these cuts would have on people in the community, as the executive director of SOWEGA Rising, a nonprofit focused on building community power in her hometown of Albany, Georgia, and its surrounding communities. She is one of many that are organizing events and advocacy in their communities. “People are facing health and economic hardships every day in our community and it’s past time that politicians start putting us first, rather than doing the bidding of the wealthiest among us,” she shared. “Taking health care and food away is not the direction we should be going as a country — it is dangerous, it is unfair, and it must stop.” 

# # # 

About Community Catalyst Action Fund: Community Catalyst Action Fund builds the power of people to create a health system rooted in race equity and health justice, and a society where health is a right for all. We strengthen the health justice and advocacy movement to achieve community-led political and policy wins that put people over profits. Learn more here.

About Protect Our Care: Protect Our Care is a nonprofit organization that is leading the fight for better health care at lower costs.

Washington, DC — Today, House Speaker Kevin McCarthy told reporters that work reporting requirements are a red line in debt ceiling negotiations. Already, House Republicans have passed a radical bill to cut Medicaid and rip coverage away from 21 million Americans — disproportionately impacting people of color, rural Americans, and people with disabilities. In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“President Biden did the right thing taking Medicaid cuts off the table in debt negotiations. Adding paperwork requirements may be a red line for McCarthy, but it means cutting off a vital lifeline for 21 million people who count on Medicaid — which is the exact result MAGA Republicans want. There is no room for work reporting requirements in Medicaid, SNAP, or TANF. 

“For Republicans who have mounted a decades-long war on American health care, these so-called work requirements serve the same purpose as the GOP ongoing efforts to repeal or sabotage the ACA — deny people the health coverage they need in order to protect tax breaks for billionaires. The American people have repeatedly rejected Republican efforts to slash American health care, and President Biden and congressional Democrats must stand firm against the GOP’s latest scheme to deny care to millions of Americans.” 

Less than a month ago, a federal judge in Texas issued a ruling revoking authorization for mifepristone, a safe and effective medication essential for reproductive care that was approved by the FDA more than 20 years ago. Not only did this ruling risk barring the use of mifepristone for safe and legal abortions for millions of American women, disproportionately harming low-income individuals, women of color, and those without regular access to a nearby health care provider – it also laid the groundwork for any judge to be able to overrule the evidence-based and scientific FDA medication approval process, throwing the entire system into chaos. 

The Supreme Court has stayed Judge Matthew Kacsmaryk’s ruling for now, allowing mifepristone to remain on the market for now, but the case is still in motion. The Fifth Circuit Court of Appeals is poised to rule on the merits of the case shortly. Read Protect Our Care’s statement on the SCOTUS order here.

23 states and 253 members of Congress – joined by physicians, health care experts, and legal experts – overwhelmingly agree that this case is built on unfounded legal arguments supported by anecdotes and cherry-picked studies. If Judge Matthew Kacsmaryk’s ruling stands, the consequences for patients would be disastrous. 

Fifth Circuit Appeal

Former FDA Officials 5th Circuit Amicus Brief: The Texas Ruling Threatens Patients’ Access to Critical Drugs That Prevent Suffering and Save Lives. A group of six former FDA officials, including David Kessler, Jane Henney, Margaret Hamburg, Michael A Friedman, Joshua Shafstein, Stephen Ostroff, and Norman “Ned” Sharpless, filed an amicus brief in support of the FDAt “In reviewing an administrative agency’s action based on the agency’s evaluation of scientific evidence, such as FDA drug approval decisions, courts have emphasized that they will uphold the action as long as it is within a zone of reasonableness and meets the standard of rationality required by the Administrative Procedure Act. In this case, instead of reviewing FDA’s approval of mifepristone and subsequent modifications to its conditions of use under this firmly established standard, the district court substituted its own opinions about FDA’s evaluation of the scientific data for the expert judgments of FDA clinicians and scientists, and on that basis overturned FDA’s approval of mifepristone. This unprecedented order turns Congress’s desired regulatory scheme on its head and opens the door to constant legal challenges of drug approvals. If allowed to stand, the district court’s order would threaten the incentives for drug companies to undertake the time- consuming and costly investment required to develop new drugs and provide patients access to critical remedies that prevent suffering and save lives.” [Former FDA Officials Brief, 5/2/23]

Amicus Brief By 23 States And The District Of Columbia: Overturning FDA Approval Has Devastating Consequences For The Industry And The Public. A coalition of 23 states—including New York, Arizona, California, Colorado, Connecticut, Delaware, Hawai‘i, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, North Carolina, Oregon, Pennsylvania, Rhode Island, Vermont, Washington, and Wisconsin—and the District of Columbia filed an amicus brief in support of an appeal: “In this case, allowing the district court to unilaterally substitute its judgment for the FDA’s determinations—in defiance of the scientific evidence and in a manner that unduly burdens rather than assures safe access—contravenes the mandate of the FDA and undermines the integrity of the FDA-approval process, with devastating consequences for the industry and the public. Providers and patients in amici States rely on the availability of thousands of FDA-approved drugs to treat or manage a range of medical conditions experienced by their residents, including asthma, HIV, infertility, heart disease, diabetes, and more. […] These harmful outcomes would cause ripple effects across the entire health system. In many amici States, the same facilities providing abortion also offer other critical services, such as pre- and post-natal care, family planning, cancer screening, and other critical forms of preventative health care. Delays resulting from increased demand for abortion procedures (in lieu of medication abortions) will obstruct access to all care offered at those facilities, inevitably resulting in higher rates of unintended pregnancy and sexually transmitted infections, barriers to early detection and treatment for breast, ovarian, and testicular cancers and chronic diseases, and worsened overall health outcomes. Underserved groups, including women of color, low-income women, people with disabilities, and LGBTQ individuals, will be hardest hit. And increasingly poor overall health outcomes will impose substantial costs on amici States and local governments. By contrast, in amici States’ experience, the alleged strains on the health care system purportedly caused by the FDA’s regulatory decisions, which the district court accepted as fact, have simply never materialized.” [New York et al. Brief, 5/1/23]

Amicus Brief By 253 Members of Congress: The Texas Ruling Poses A Serious Health Risk & Would Erect Additional Barriers To Health Care. “[T]he district court’s stay of the U.S. Food and Drug Administration’s September 28, 2000 Approval of mifepristone and other challenged agency actions has no basis in law, threatens the Congressionally mandated drug approval process, and poses a serious health risk to pregnant individuals by making abortion more difficult to access […] [T]he district court’s order not only misapplies the law but also threatens to harm members of the public, many of whom rely on the availability of mifepristone for reproductive care—and many more of whom rely on the integrity of FDA’s drug approval process for continued access to life-improving and lifesaving drugs. Congress intended to—and did—vest authority in FDA to evaluate and ensure the safety and efficacy of drugs in the United States, and amici call on this Court to give due weight to that intent.  […] By curtailing access to the most common method of medication abortion, the district court’s order would erect additional barriers to health care for vulnerable populations. Reduced abortion access is also associated with higher rates of poverty, and lower educational attainment for both children and parents. The unavailability of mifepristone will have an especially acute impact on Black maternal health. In 2020, maternal death rates were 62 percent higher in abortion-restriction states than in abortion access states.” [253 Members of Congress Brief, 5/1/23]

Former DOJ Officials Amicus Brief in Alliance for Hippocratic Medicine v. FDA. “In this brief, former high-ranking officials from both major parties, who hold opposing views on the moral and jurisprudential aspects of abortion, argue the District Court wrongly assumed that the FDA has the authority under the Food, Drug & Cosmetic Act to consider unrelated laws when it reviews applications for approval of new drugs. FDA’s role is to determine the safety and efficacy of drugs based on scientific evidence and not to purport to enforce laws over which they do not have enforcement authority. Amici also demonstrate how the court’s interpretation of the Comstock Laws from 1873—federal anti-vice law that criminalizes the mailing of abortion drugs when intended for use in unlawful abortions—was wrong and its rejection of DOJ’s interpretation of those laws misplaced.” [Former DOJ Officials Brief, 4/13/23]

Motion To Stay

Amicus Brief By 240 Members of Congress: Texas Ruling Second-Guessed Scientific Determinations with Cherry-Picked Anecdotes To Upend the Status Quo. “The district court appears to have second-guessed FDA’s scientific determinations with cherry-picked anecdotes and studies, and on that basis, imposed a remedy that could significantly upend the status quo. […] the district court’s misguided stay under Section 705 of the Administrative Procedure Act will reduce access to abortion, exacerbating an already significant reproductive health crisis,” write the lawmakers, adding: “The consequences of the district court’s remedy could extend far beyond mifepristone, for it undermines the science-based, expert-driven process that Congress designed for determining whether drugs are safe and effective. […] Its perilous consequences reach far beyond mifepristone. Providers and patients rely on the availability of thousands of FDA-approved drugs to treat or manage a range of medical conditions, including asthma, HIV, infertility, heart disease, diabetes, and more.” [240 Members of Congress Brief, 4/11/23]

Former FDA Officials Supreme Court Amicus Brief: This Ruling Puts the Country on a Dangerous Path Towards a Piecemeal Regulatory Scheme Congress Already Rejected in 1938. “Courts lack the expertise to step into FDA’s shoes by second-guessing FDA’s experts on the safety and efficacy of drugs. Assuming that role would require in expert judges to learn how to do what FDA’s expert pharmacologists, toxicologists, chemists, epidemiologists, physicians, and data scientists have spent lifetimes training to do. Getting it wrong can lead to catastrophic consequences—measured not in dollars, but in human lives— and deprive patients of life-saving medication they depend upon. FDA’s modern authority over drug approvals evolved in response to a series of public health crises that occurred over the last century. In response to these crises, Congress steadily expanded and centralized FDA’s authority over drug approvals to give FDA more discretion to protect public health. Congress codified FDA’s accelerated approval authority in 2012, when it passed the Food and Drug Administration Safety and Innovation Act.” [Former FDA Officials SCOTUS Brief, 4/17/23]

Pharmaceutical Companies 5th Circuit Amicus Brief: Texas Ruling Will Shatter the FDA’s Gold Standard Approvals Method. ““[T]he opinion identified no errors in FDA’s scientific judgment or calculations. Instead, the court proffered its own, competing analysis, which lacked any evidence that could support the type of rigorous scientific decision-making with which FDA is tasked. The court cast aside not only the voluminous scientific evidence FDA considered at the time of approval, but also nearly a quarter century of subsequent data showing safe and effective use of the drug. In its place, the court relied on personal stories told by plaintiffs and cherry-picked, unreliable publications—many of which were not even submitted to FDA. The court then ruled that FDA was required to refuse to approve the NDA based on the court’s own non-scientific assessment of this alternative, incomplete record.” [Pharmaceutical Companies, Executives, And Investors Brief, 4/11/23]

NAACP Legal Defense Fund 5th Circuit Amicus Brief: Texas Ruling Directly Undermines the Supreme Court and the Public Interest. “Because the district court’s opinion will impact the availability of mifepristone in all 50 states, it is contrary to the minimal assurances provided for in Dobbs. Justice Kavanaugh’s concurrence emphasized that the Dobbs decision ‘does not prevent the numerous States that readily allow abortion from continuing to readily allow abortion’ and that all states ‘may evaluate the competing interests and decide how to address this consequential issue.’ Rather than leave it to individual states to ‘readily allow abortion,’ as encouraged by Justice Kavanaugh, the district court’s order disallows the two-step medication abortion option entirely. The Supreme Court opined thirty years ago that ‘[t]he ability of women to participate equally in the economic and social life of the Nation has been facilitated by their ability to control their reproductive lives.’ Increased abortion access has had a demonstrably positive economic impact on women, and on Black women, in particular. A review of the data from 2020 among states that report racial and ethnic data on abortion patients indicates 39 percent identify as non-Hispanic Black, and among those aged 15-44 there were 24.4 abortions per 1,000 non-Hispanic Black women. When people can decide if, when, and how many children to have, they are able to make conscious determinations about other aspects of their lives.” [NAACP Legal Defense And Educational Fund Brief 4/11/23]

American College of Obstetricians and Gynecologists 5th Circuit Amicus Brief: The District Court Relied on Biased and Flawed Studies to Justify Ruling. “Without any form of the evidentiary hearing and in complete disregard to the overwhelming body of evidence proving that mifepristone is safe, the District Court’s order (the “Order”) purports to suspend the use of treatment essential to amici’s patients, in order to further its own ideological agenda and that of Appellees. The decision is rife with medically inappropriate assumptions and terminology. It disregards decades of unambiguous analysis supporting the use of mifepristone in miscarriage and abortion care. It relies on pseudoscience and on speculation, and adopts wholesale and without appropriate judicial inquiry the assertions of a small group of declarants who are ideologically opposed to abortion care and at odds with the overwhelming majority of the medical community and the FDA.” [Medical and Public Health Societies Brief, 4/11/23]

Doctors for America 5th Circuit Amicus Brief: Banning the Use of Mifepristone Would Endanger the Health of Patients. “An injunction reversing the approval of mifepristone would remove the availability of an evidence-based treatment that is the safest and best option for many patients. As physicians describe… the removal of mifepristone would undermine their ability to provide safe and effective management of early pregnancy loss.” [Doctors for America Brief, 2/13/23]

Washington, DC — Today, Representative Lauren Underwood (D-IL-14) introduced the Black Maternal Health Momnibus Act of 2023, which is a package of 13 bills to address critical drivers of maternal mortality. Black women are three times more likely to die from pregnancy-related complications than White women in the United States. Maternal mortality in the United States is higher than in any high-income nation. An estimated 80 percent of these deaths are preventable, and the problem is getting worse: recent CDC data show a 40 percent increase in maternal deaths between 2020 and 2021, making passing the Momnibus legislation and requiring Medicaid to provide 12 months of postpartum coverage more urgent than ever before. In response, Protect Our Care Chair Leslie Dach released the following statement:

“It is unacceptable that the United States loses more moms to preventable pregnancy-related deaths than any other high-income country, and this problem has only worsened over the past 30 years. This tragedy disproportionately befalls Black, Indigenous, and rural families. The Black Maternal Health Momnibus Act is essential legislation that addresses the leading causes of poor maternal health outcomes, and it will save lives and help end the maternal health crisis. Protect Our Care commends Representatives Underwood and Adams and Senator Booker for their tireless leadership to improve the pregnancy, birthing, and postpartum experience in America. Congress should pass this legislation without delay.” 

White House Confirms President “Will Not Accept Proposals that Take Away People’s Health Coverage”

Washington, DC — Over the weekend, President Biden committed to protecting health care for millions of Americans as Republicans are seeking to rip away coverage for as many as 21 million people who rely on Medicaid through their extreme “Default on America Act.” 

President Biden told reporters Medicaid is off the table while the White House confirmed “he will not accept proposals that take away peoples’ health coverage.” The President reinforced this commitment today. A record 92 million people in America are covered by Medicaid – mostly seniors, children, and people with disabilities – but the GOP is seeking serious cuts to Medicaid and 22 percent cuts to research for cancer cures, veterans health care, and other vital health care programs. Republicans have proposed bureaucratic reporting requirements, which will only result in millions losing coverage. Read more about how Republicans are demanding health care cuts here. 

In response, Protect Our Care Chair Leslie Dach issued the following statement:

“President Biden made it very clear that he is not going to let Republicans hold our economy and the American people hostage in exchange for millions of people losing their health care. If the GOP gets their way, 21 million Americans risk  losing their health care coverage because of bureaucratic barriers and red tape. This would disproportionately harm people with disabilities or behavioral health disorders, caregivers, people of color, and rural Americans.  By standing up to GOP health care sabotage, President Biden is standing up for the American people. If Republicans truly cared about working families, they wouldn’t continue to put support for tax cuts for the wealthy before ensuring every American has affordable health care.”

Watch the Event Here.

Washington, DC — Today, National President and CEO of the American Lung Association Harold Wimmer, Associate Executive Director for Public Affairs and Advocacy of the American Public Health Association Susan Polan, and Andrew Pincus joined Protect Our Care for a virtual press conference to discuss the new amicus briefs ahead of the upcoming stay decision from the Fifth Circuit in Braidwood Management v. Becerra. U.S. District Judge Reed O’Connor’s March 30 decision would end ACA’s guaranteed free access to essential preventive services. In 2020 alone, more than 150 million Americans benefited from these preventive services.  

Judge O’Connor invalidated all of the benefits covered under the U.S. Preventive Services Task Force, including lifesaving lung, breast, and colorectal cancer screenings, anxiety and depression screenings for children and adults, heart disease screenings, intimate partner violence screenings, and access to PrEP (pre-exposure prophylaxis), which can reduce the chance of contracting HIV. The ruling applies nationwide. 

“Navigating the health care system is confusing and challenging, and this court case is increasing confusion and uncertainty for patients’ access to preventive services,” said Harold Wimmer, National President and CEO, American Lung Association. “A robust body of research has shown that even modest cost barriers can reduce uptake of preventive services, especially for patients in socioeconomically vulnerable populations. If the lower court’s ruling stands, fewer people will be screened for lung cancer, their cancer will be detected at later stages, and we will lose more people to this devastating disease.” 

“These preventive services help people live longer and healthier lives,” said Susan Polan, Associate Executive Director for Public Affairs and Advocacy, American Public Health Association. “The ACA made highly effective, evidence-based preventive services available more than ever before. Preventive services should be available to everyone. It shouldn’t matter where you live or how you get your health care. The impact of this decision on the public’s health, especially for people of color, will be disastrous. It’s not the time to go backwards.”

“The key issue courts consider in connection with a stay is the ‘balance of the harms.’ The greatest threat here is the harm to patients if a stay is not granted and the ACA’s protection against cost-sharing is eliminated nationwide,” said Andrew Pincus, Visiting Lecturer in Law at Yale Law School and experienced Supreme Court and appellate lawyer. “We know conclusively, from a mountain of data, that if patients have to bear even part of the cost of these preventive services they will not use them – and that will mean diseases won’t be prevented, or won’t be detected at early stages, and more Americans will suffer severe illnesses and deaths. If a stay is granted, companies and insurers will not suffer any increased burden: they just will have to continue to provide the cost-free coverage they’ve been providing for years.  And if the plaintiffs are correct that few companies would even choose to impose cost-sharing, then the burden of continuing the law’s protection is minimal.  Congress determined in the ACA that cost-free access to preventive services significantly enhances public health. The balance of these factors therefore weighs very heavily in favor of the stay.”

“If O’Connor’s decision stands, it will be a tragedy for millions of Americans,” said Leslie Dach, Chair of Protect Our Care. “Free screenings for depression, diabetes, and heart health not only saves families money, but it saves lives. Without this guarantee, more Americans will be forced to choose between going to the doctor and paying for other essentials like groceries and rent — meaning more Americans will get sick and more will die of entirely preventable causes.”

Leading Patient and Provider Groups, Public Health Experts, and Advocates Call for a Stay of Judge O’Connor’s Reckless Ruling to Rip Away Free Preventive Care From Millions

In March 2023, District Judge Reed O’Connor struck down portions of the Affordable Care Act (ACA) that require insurers to cover lifesaving preventive services without cost sharing. The ruling puts millions at the mercy of insurance companies and employers, who could eliminate the benefits entirely or start charging for them, increasing costs for patients by thousands of dollars a year and creating major obstacles to care.

Eliminating costs for these lifesaving screenings and services has transformed how preventive care is delivered, saved countless lives, improved health outcomes, reduced disparities in care, and cut consumer health care costs for more than 150 million people. Guaranteed no-cost coverage of preventive services, including screenings for chronic disease, is critical to ensuring everyone has access to the same quality health care, no matter where they live or the color of their skin. 

The Fifth Circuit Appeals Court is expected to decide on a stay of the ruling shortly. Patient and provider groups, public health experts and organized labor — including the American Medical Association, the American Lung Association, the American Cancer Society, SEIU, the American Public Health Association and 68 academic deans and scholars, and dozens more organizations — overwhelmingly agree that this case is built on an unfounded legal arguments and have submitted briefs affirming that, if Judge Reed O’Connor’s ruling stands, the consequences for patients would be disastrous.

Federal Government

Department of Justice: “The Public and the United States Will Face Significant Harm” Unless the Ruling Is Stayed. “[T]he public and the United States will face significant harm if the broad and universal relief ordered is not stayed during the pendency of this appeal. […] Collectively, the vacated and enjoined coverage requirements have ensured that more than 150 million Americans can benefit from the above-listed and other preventive services without cost sharing. ROA.2170. Absent a stay, those people will lose the federally-backed protection that their health plans must include that coverage, or the ability to have those services covered without cost sharing. Available data suggests that more than a third of group health plans (which, in 2020, covered approximately 14 million participants) may begin new plan years before January 1, 2024. That includes more than 20% of group health plans (which, in 2020, covered approximately 6.3 million participants) that may start a new plan year prior to July 1, 2023. ROA.2179. Many additional plans will begin new plan years in January 2024. If the nationwide vacatur and injunction ordered by the district court remain in effect pending appeal, many of these plans could either eliminate coverage of the relevant preventive services or impose cost sharing for those services.” [Department of Justice, Motion For A Partial Stay Of Final Judgment Pending Appeal, 4/27/23]

Health Care Organizations and Advocates

American Hospital Association et al. Fifth Circuit Amicus Brief: Preventive Care Is Essential to Population Health And A Stay Is In The Public Interest. A coalition comprising 12 top public health organizations—the American Hospital Association, Federation of American Hospitals, the Catholic Health Association of the United States, America’s Essential Hospitals, and the Association of American Medical Colleges—filed an amicus brief in support of an appeal to Judge Reed O’Connor’s ruling: “Evidence-based preventive-care services free from political influence are essential to patient wellbeing and population health and lead to lower health care costs over the long term. Upending coverage of preventive-care services will increase the risk that acute illnesses or chronic diseases will not be timely detected or treated. […] Estimates show that an increased uptake of recommended preventive services could save over 100,000 additional lives every year. […] In addition to providing vital screenings, the ACA’s preventive-care coverage requirement ensures access to life-saving medications. […] Without zero-cost-sharing access to PrEP, many at-risk populations—particularly Black and Hispanic adults—will face an increased chance of contracting HIV. […] The ACA’s preventive-care coverage requirement saves lives and improves population health, saving the public costs in the long term. Maintaining these benefits pending appeal is therefore in the public interest.” [American Hospital Association et al. Brief, 5/4/23]

American Medical Association et al. Fifth Circuit Amicus Brief: Ruling Threatens to Reverse Recent Public Health Advancements Must Be Stayed. A coalition comprising 12 top public health organizations—the American Medical Association, American College Of Obstetricians And Gynecologists, Society For Maternal-Fetal Medicine, American Academy Of Pediatrics, American Medical Women’s Association, American Academy Of Family Physicians, National Medical Association, Infectious Diseases Society Of America, American College Of Chest Physicians, American Thoracic Society, National Hispanic Medical Association, and American Society Of Clinical Oncology—filed an amicus brief in support of a motion to stay Judge Reed O’Connor’s ruling: “As professional organizations representing physicians across the country, Amici know that no-cost preventive care saves lives, saves money, improves health outcomes, and enables healthier lifestyles. Ensuring that patients can receive these services is of the utmost importance to public health. The district court’s unprecedented decision imperils access to these services nationwide. Amici file this brief to inform this Court of the repercussions that decision could have on preventive care access. […] 151.6 million individuals currently have private health coverage that covers preventive services with zero cost-sharing,” including “approximately 58 million women, 57 million men, and 37 million children.” The Task Force requirements can also apply to Medicaid expansion enrollees, adding another 20 million adults,10 and to Medicare enrollees, if HHS has determined that a given service is appropriate for inclusion in the program, adding 61.5 million individuals more.11 In other words, approximately 233 million individuals are currently enrolled in plans that must cover preventive services without cost-sharing. […] Finally, the availability of no-cost preventive care has improved utilization and health outcomes among populations that have historically faced difficulty accessing health care. In particular, a recent study concluded that “[g]iven the large differences in the share of uninsured and the use of clinical preventive services among Black and Hispanic adults relative to White adults pre-ACA, the ACA does appear to have reduced the differences between minority adults and White adults.” Eliminating coverage requirements would impose further barriers, making it even harder to ensure that patients receive the requisite care.” [American Medical Association et al. Brief, 4/28/23]

American Lung Association et al. Fifth Circuit Amicus Brief: Ruling Could Hold Hazardous Consequences for Public Health Unless Stayed. A coalition comprising eight primarily public health-oriented non-profit organizations—the American Lung Association, Adult Vaccine Access Coalition, American Heart Association, Campaign for Tobacco-Free Kids, GO2 for Lung Cancer, LUNGevity Foundation, Public Citizen, and Truth Initiative—filed an amicus brief in support of a motion to stay Judge Reed O’Connor’s ruling: “The provisions of the Affordable Care Act (ACA) that require insurers to provide coverage for certain preventive services without cost to patients reflect Congress’s recognition that barrier-free access to preventive care is critical for safeguarding Americans’ health. The district court’s judgment upends Congress’s careful policy choices and creates the risk that insurers will reinstate cost-sharing for vital preventive services or even exclude them from coverage entirely. To avoid the hazardous consequences the district court’s judgment could hold for public health, this Court should stay the judgment pending appeal. […] If preventive care costs increase even for “just” a few million Americans, the health consequences could be serious…If insurers now respond to the district court’s judgment by imposing cost-sharing requirements for patients to receive these life-saving medications, research suggests that patients could discontinue use despite the risks to their health…More broadly, according to a recent survey, 40 percent of American adults would be unable or unwilling to pay out of pocket for the majority of the evidence-based preventive services affected by the district court’s judgment.” [American Lung Association et al. Brief, 4/27/23]

American Cancer Society et al. Amicus Brief: Ruling Substantially Harms Our Patients and Must Be Stayed. A coalition comprising 15 public health organizations—the American Cancer Society (ACS), American Cancer Society Cancer Action Network (ACS CAN), American Kidney Fund (AKF), Arthritis Foundation, CancerCare, Cancer Support Community (CSC), Cystic Fibrosis Foundation, Epilepsy Foundation, Hemophilia Federation of America, Leukemia and Lymphoma Society (LLS), National Minority Quality Forum (NMQF), National Multiple Sclerosis Society, National Patient Advocate Foundation, The AIDS Institute, and WomenHeart—filed an amicus brief in support of a motion to stay Judge Reed O’Connor’s ruling: “All Americans use or will use health care services, and the lifetime risk that individual Americans will contract one of the diseases or conditions towards which amici direct our efforts is high. Preventive services can aid in prevention, early detection and treatment of many diseases, which increases patients’ chances of survival and extends life expectancies. Preventive care also helps control patients’ costs of treating these diseases and conditions. […] A review of 65 papers published from 2000-2017 found that “even relatively small levels of cost sharing in the range of $1 to $5 are associated with reduced use of care, including necessary services.”…two out of five respondents stated that they would not pay out of pocket for eleven out of twelve preventive services included in the survey. […] The U.S. District Court’s March 30 decision threatens to imminently and drastically reduce insurance coverage of preventive services, deter utilization of those services, and worsen patient outcomes. Without a stay, the District Court’s order will substantially harm the patients amici serve and support.” [American Cancer Society et al. Brief, 4/28/23]

Physicians and Health Care Experts

American Public Health Association & Public Health Deans and Scholars Fifth Circuit Amicus Brief: Ruling Could Cause Irreparable Harm By Limiting Access to Life-Saving Services and Must Be Stayed. A group of 68 distinguished academic deans and scholars of public health, alongside the American Public Health Association, filed an amicus brief in support of a motion to stay Judge Reed O’Connor’s ruling: “To protect Americans’ health, the ACA requires virtually all private insurance plans to cover critical preventive services cost-free. And the statute relies on a body of medical experts to identify the services that qualify for that coverage. The district court’s nationwide order eliminates this requirement for dozens of life-saving services. If it is not stayed, some companies and insurers will re-impose cost-sharing—indeed, some plans could impose cost-sharing with just sixty days’ notice. As a result, many Americans will not use these services: studies consistently demonstrate that when people are required to pay part of the cost of preventive care, they often do not obtain it. That will lead to more serious illnesses and even deaths among the individuals deprived of coverage. It also will affect Americans more broadly, because many of the covered services prevent and treat illnesses that, if not detected and treated, can be spread among the population generally. […] A stay will maintain the status quo for the more than 150 million Americans who rely on cost-free coverage for preventive services. By contrast, the district court’s order will inflict irreparable harm by causing many Americans to suffer serious and life-threatening conditions and illnesses that otherwise would have been avoided. That harm is not outweighed by the temporary exclusion of non-parties from the relief granted by the district court.” [American Public Health Association and Public Health Deans and Scholars Brief, 4/28/23]

Service Employees International Union (SEIU) Fifth Circuit Amicus Brief: Ruling Will Threaten The Healthcare of More Than 130 Million Employees Unless Stayed. “SEIU respectfully urges the Court to grant Defendants-Appellants’ (“Defendants”) motion for a partial stay of the district court’s nationwide judgment. That judgment threatens the healthcare of the more than 130 million employees and families with private employment-based insurance plans by enjoining Defendants from taking any action to enforce or implement the requirement that preventive care services recommended by the Preventive Services Task Force (“Task Force”) be provided at no cost. As borne out by the experiences of SEIU’s physician members, the mandate to make preventive care available at no cost has saved lives, and the district court’s decision, by reducing access to that care, will negatively affect millions of Americans’ health. Yet the district court, in flagrant disregard of the governing legal standards, failed even to address or acknowledge the significant negative effects its judgment will have on millions of non-parties. The district court’s judgment also interferes with the statutory and due process rights of non-party employees and their families. […] Many of those affected workers are SEIU members. Yet the interests of employees and their families in retaining access to preventative care services are not adequately represented in this case by the agency Defendants-Appellants.” [SEIU Brief, 4/28/23]

New Navigator polling reveals that voters strongly oppose House Republicans’ plan to take away Medicaid. A striking 85 percent of voters are concerned about the impact of their plan to “take Medicaid away from as many as 21 million people…including kids with disabilities, seniors in assisted living, and pregnant women.” The ‘Default on America Act’ also slashes funding for veterans’ health care, nursing home safety, mental health and substance use services, and more. Not only are these measures widely unpopular, but they threaten the health and well-being of millions of families across the nation. Read more on their disastrous bill here.

When forced to choose the most harmful outcomes for our country, people identify taking away things like Medicaid and cutting veterans benefits as the most harmful with defaulting on the debt coming in second. Compared to both of these alternatives from the GOP, Americans would find “raising the debt ceiling” to be far less problematic.