Six national aging groups filed a friend of the court brief with the Supreme Court last Friday, January 27, saying that there are extensive provisions in the Patient Protection and Affordable Care Act that are of “vital importance to the health and well-being of people 65 and older” and that Congress did not intend for any of them to be contingent on whether or not the minimum coverage provision (also called the individual mandate) was constitutional.

“The health and quality of life of many older Americans are already improving because of the health reform law,” says National Senior Citizens Law Center Executive Director, Paul Nathanson. “We don’t believe Congress intended to let the elderly poor languish in nursing homes or be subject to abuse if the individual mandate was found unworkable.”

The amicus brief was filed in the National Federation of Independent Business et al v Kathleen Sebelius et al and the State of Florida et al v Department of Health and Human Services et al cases which challenge the constitutionality of the health reform law. In those cases, the petitioners contend that all of the ACA should fall if the minimum coverage provision is invalidated by the Court.

The brief states that a “careful review” of policies Congress sought to enact shows that the provisions affecting people aged 65 and over “can be effectuated without any reliance on the minimum coverage provision.”

The brief also highlights the parts of the ACA that greatly benefit people aged 65 and older that should not be affected if the Court decides to invalidate the minimum coverage provision, including the following:

• Reduced cost-sharing for Medicare beneficiaries for prescription drugs by substantially reducing the coverage gap or so-called donut hole
• Elimination of cost-sharing for annual wellness visits and other screening services
• Medicare Advantage plans are prevented from charging higher cost-sharing for chemotherapy and dialysis than permitted under traditional Medicare
• Decreased unnecessary institutionalization of Medicaid beneficiaries
• Improved coordination of care for people receiving both Medicare and Medicaid (dual eligibles)
• Improved quality and safety in nursing homes, and prevention of abuse and neglect of elderly and people with disabilities in nursing and other residential facilities.

The brief states that the only provisions that should be affected by the constitutionality of the minimum coverage provision are the pre-existing condition, the community rating, and guaranteed issue provisions.

“The rest of the ACA, including, but in no way limited to the provisions highlighted in this amicus brief, should remain intact,” the brief concludes.

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