Press Release

Attorney General Ellison defends Affordable Care Act in court

Joins coalition of 21 attorneys general in filing opening brief in Texas v. US

March 26, 2019 (Saint Paul) — Minnesota Attorney General Keith Ellison joined a coalition of 21 attorneys general, led by California Attorney General Becerra, in filing an opening brief in Texas v. U.S. in defense of the Affordable Care Act (ACA) and the healthcare of millions of Minnesotans and tens of millions of Americans. The brief, filed in the U.S. Court of Appeals for the Fifth Circuit, argues that every provision of the ACA remains valid. It also details the harm that declaring the ACA invalid would have on the tens of millions of people who rely on it for access to high-quality, affordable healthcare, as well as the broader damage that it would do to the nation’s healthcare system.

The states’ opening brief was filed yesterday about three hours before the U.S. Department of Justice letter informing the Fifth Circuit that it is entirely abandoning its defense of the Affordable Care Act.

“Preserving the Affordable Care Act is for some people a matter of life or death, and for millions of others a matter of whether they can afford healthcare at all,” Attorney General Ellison said. “The ACA was a big step forward in helping people afford their lives and live with dignity and respect. It was also the greatest step forward in expanding access to affordable healthcare since Medicaid, and it held insurance companies accountable, too. 

“The fact that the Justice Department has now changed its position and is encouraging the court to uphold striking down the entire ACA is another clear sign that the President is not on the side of Minnesotans or the American people,” Attorney General Ellison added.

The potential impacts on Minnesotans of striking down the ACA in its entirety are dire:

• More than 2,300,000 Minnesotans with a pre-existing condition would be at risk of being charged unaffordable premiums or being denied coverage altogether.
• Minnesota’s rate of uninsured people fell from 9 percent in 2009 to 6.3 percent in 2017. This represents more than 250,000 people. This number includes a large fraction of the people covered by MNsure, an estimated 38,000 young adults who gained coverage by staying on their parents’ health insurance, and those gaining coverage from the law’s Medicaid expansion and employer shared-responsibility policy. This coverage would be at risk if the ACA were struck down.
• More than 2,700,000 Minnesotans, including more than 1,000,000 women ages 15–64, would lose the federal guarantee of preventive services — such as flu shots, cancer screenings, and contraception — which are now provided at no extra cost to consumers.
• Approximately 212,000 Minnesotans who are enrolled in the Medicaid-expansion population would be at risk of losing their coverage. The ACA provided the authority for Medicaid to cover adults without minor children who are not disabled whose income is less than 133 percent of the poverty level, which means that private insurance is out of range. Prior to the ACA, these individuals received some coverage through various state-funded programs.
• Approximately 82,000 Minnesotans who are enrolled in the Basic Health Program — for people who earn between 133 percent and 200 percent of poverty and do not have employer-provided insurance — would be at risk of losing their coverage.

The plaintiffs, two individuals and 18 states led by Texas, filed this lawsuit in February 2018, challenging one provision of the Affordable Care Act — the requirement that individuals maintain health insurance or pay a tax. Texas’ lawsuit came after Congress reduced that tax to zero dollars in December 2017. The plaintiffs argued that this change made the minimum coverage provision unconstitutional. They further argued that the rest of the ACA could not be “severed” from that one provision, so the entire Act must be struck down.  

Opponents of the ACA had attempted and failed to repeal the ACA more than 70 times since it was enacted.

On December 14, 2018, Judge Reed O’Connor of the Northern District of Texas issued his decision agreeing with the plaintiffs. In response, Attorney General Ellison joined Attorney General Becerra and the coalition of Attorneys General in filing a motion to stay the effect of that decision and to expedite resolution of this case. The District Court granted that motion on December 30, 2018. On January 3, 2019, the coalition of Attorneys General continued their legal defense in the ACA and formally filed a notice of appeal, challenging the District Court’s December 14 opinion in the Fifth Circuit.

Today’s filing continues the legal defense of the ACA. In the brief, Attorney General Ellison and the other attorneys general argue that the plaintiffs do not have standing to challenge the minimum coverage provision, because the individual plaintiffs are not injured by a provision that now offers a lawful choice between buying insurance and paying a zero-dollar tax. They further argue that the state plaintiffs also lack standing, because there is no evidence that the amended provision will require them to spend more money. Lastly, the District Court wrongly concluded that the minimum coverage provision was unconstitutional, and even if it were there would be no legal basis for also declaring the rest of the ACA invalid—including its provisions expanding Medicaid, reforming Medicare, and providing protections to individuals with preexisting health conditions.

The opening brief is available on the website of California Attorney General Xavier Becerra.