As the U.S. Supreme Court gears up for oral arguments, two HIV/AIDS heavyweights are urging justices to find the Patient Protection and Affordable Care Act ( ACA ) constitutional.
Lambda Legal and the National Minority AIDS Council ( NMAC ) earlier this year filed friend-of-the-court briefings. Each amicus brief details how the ACA will improve access to care and augment prevention services.
"The ACA is a crucial bridge between the current state of the domestic epidemic and a future that is free from AIDS," said Scott Schoettes, Lambda Legal's HIV project director. "When Congress enacted the ACA in 2010, only 17% of people living with HIV had private health insurance... With continuing prevention education, early detection, and quality care for everyone living with HIV, we have the power to stem the HIV/AIDS epidemic."
The ACA was signed into law in March 2010. Its principle provisions included an expansion of healthcare access and several industry practice reforms, such as changes to pre-existing condition clauses.
The law's constitutionality was immediately challenged in federal courts, and the U.S. Supreme Court will begin to weigh in on cases this month.
In its briefing, NMAC urged the Court to uphold the ACA's Medicaid expansion, which would eliminate current disability requirements and expand eligibility to those making up to 133 percent of the federal poverty level.
Presently, low-income citizens who are HIV-positive are not eligible for Medicaid until they are disabled by an AIDS diagnosis.
" [ The ] current Medicaid eligibility requirements lack both sense and humanity," said NMAC Director of Legislative and Public Affairs Kali Lindsey. "They create a system in which individuals must be diagnosed with AIDS in order to gain access to the very treatments that could have prevented that diagnosis in the first place. This endangers the health of the very people that Medicaid is meant to serve, while raising program costs by delaying care until the latest stages of the disease."
For its part, Lambda Legal focused on the link between the ACA, healthcare and prevention. Lambda argued the federal government's controversial individual mandate is, in fact, constitutional under the Commerce and Necessary and Proper clauses.
"The ACA's interconnected reforms … are a proper exercise of Congress's power to address a broken national healthcare finance system and directly expand access to health insurance for millions of people living with HIV," said Susan Sommer, Lambda Legal's director of constitutional litigation.
Sommer continued: "Congress has acted many times in the past to prevent the exclusion of particular groups from interstate markets. It undoubtedly has the power to take such action to allow people with pre-existing conditions, like HIV, to participate in the national healthcare insurance market."
Four national organizations, including amFAR and the HIV Medicine Association, joined NMAC in its filing; more than 130 organizations have endorsed Lambda Legal's amicus brief.
The ACA is widely considered the most prolific HIV/AIDS legislation since the Ryan White CARE Act.
"The list of supporters for our brief … continues to grow because of the law's enormous potential to impact the domestic AIDS epidemic," Schoettes said.
This story is part of the Local Reporting Initiative, supported in part by The Chicago Community Trust.