An Interview with Catherine Strode
The national Arc is fighting a 2018 ruling in a Texas U.S. District Court that determined the Affordable Care Act (ACA) unconstitutional. That case is now pending in the U.S. Court of Appeals for the Fifth Circuit. The Arc has joined 14 other national organizations representing people with disabilities in filing an amicus brief appealing to reverse the lower court’s decision.
The Chief Executive Officer of the Arc of the United States, Peter Berns, has called the lower court’s decision “an extraordinary threat” for people with disabilities and their families. He says if the ACA is taken off the books, it will set the advocacy efforts for individuals with intellectual or developmental disabilities (IDD) back 70 years.
What was the reason for the Arc joining in the filing of the amicus brief?
The Arc has gotten involved in this case because of the importance of that law to our constituents. This case threatens the very existence of the Affordable Care Act. The ACA is perhaps the most important positive development in the law that benefits people with intellectual or developmental disabilities in the past 25 years or more. There are a variety of reasons why the ACA is so important. First of all, it makes health care much more widely available to people with disabilities. It prevents insurers from limiting coverage based on preexisting conditions. It also prevents insurers from imposing annual or lifetime caps. It also has a variety of other provisions in it that are important for people with disabilities.
What do you see as the purpose of the brief?
The purpose of the amicus brief was to highlight for the court the importance of the law to people with disabilities, particularly to those with IDD. The courts may generally understand what would be at stake with doing away with the ACA as it relates to the general population. That is folks who are getting health care through the Act or who are benefitting from the Medicaid expansion. What we sought to do in the brief is to shine a light specifically on the importance of the law to people with disabilities and the issues they face. This includes: preexisting conditions; lifetime and annual caps; and the fact that the Medicaid program (which was expanded under the ACA) is the single most important and largest source of funding for home and community-based services for people with disabilities. The lawsuit is part of a consistent effort by some states and the current administration to undo the ACA. The current administration, in deciding not to defend the ACA, is risking wreaking havoc on the lives of people with IDD and their families.
On what basis did the lower court find the ACA unconstitutional?
The suit was brought by state attorney generals representing 20 states that did not want to expand Medicaid. Congress had authority to enact the ACA under the Commerce Clause of the Constitution and under its taxing powers. When an earlier court decided that a tax could not be assessed for the mandate to buy coverage, opponents of the law argued that Congress didn’t have authority to enact this law under its general authority to regulate commerce in the U.S. The District Court bought that argument. It found that, once the mandate was thrown out, Congress no longer had authority to enact the law under the Commerce Clause. That’s the issue that is now pending in the Fifth Circuit Court of Appeals. It’s the question of, “If one provision of the law has been invalidated, does that mean the whole thing has to be thrown out as unconstitutional?” This is most likely going to go all the way up to the U.S. Supreme Court.
What proactive steps can state and local chapters take to protect health insurance for people with disabilities?
One of the most important things that chapters of the Arc can do is to make sure that all of your constituents are educated about these issues, to have them speak out to their members of Congress about their concerns of being excluded by preexisting conditions, of continuing to be eligible for Medicaid. They can tell their personal stories about the importance of the availability of health insurance to them. This lawsuit is an extraordinary threat. The powers that be are continuing to attack the ACA, chipping away at the ACA in a variety of different ways. They are trying to inflict a death by a thousand cuts. We need our representatives in Congress to understand that, for people with disabilities and their families, this is a matter of life and death. This is a matter that impacts whether people can be included in their communities and live a decent life like everybody else. We need to continue to be vocal on these issues indefinitely into the future. If we lose the ACA, it’s a giant step backwards.
Catherine Strode is Advocacy Denver’s Communications and Policy Specialist. She holds a Masters degree in Public Administration with an emphasis in Health Care Policy. Catherine publishes Policy Perspective, featuring interviews with state policy makers on issues that affect the work and mission of Advocacy Denver.