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Amicus Brief Nos. 19-840 & 19-1019 In The Supreme Court of the United States _______________________ CALIFORNIA, ET AL., Petitioners, v. TEXAS, ET AL., Respondents. _________________ TEXAS, ET AL., Petitioners. v. CALIFORNIA, ET AL., Respondents, _________________________ ON WRITS OF CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT __________________________________ BRIEF OF AMICI CURIAE AARP, AARP FOUNDATION, CENTER FOR MEDICARE ADVOCACY, AND JUSTICE IN AGING IN SUPPORT OF PETITIONERS IN NO. 19-840 AND NON-EXECUTIVE BRANCH RESPONDENTS IN NO. 19-1019 ___________________________________ Regan Bailey Maame Gyamfi* Natalie Kean *Counsel of Record Carol Wong William Alvarado Rivera JUSTICE IN AGING Kelly Bagby AARP FOUNDATION Alice Bers 601 E Street, NW Wey-Wey Kwok Washington, DC 20049 David Lipschutz T: (202) 434-6291 CENTER FOR MEDICARE [email protected] ADVOCACY Counsel for Amici Curiae i TABLE OF CONTENTS Page STATEMENT OF INTERESTS OF AMICI CURIAE ...................................................................... 1 SUMMARY OF ARGUMENT .................................... 3 ARGUMENT ............................................................... 5 I. The ACA Is A Stabilizing Force That Benefits Millions of Older Adults Who Could Not Access or Afford Health Care Without It. ............................................... 5 II. Invalidating The ACA Would Cause Millions Of Older Adults To Lose The Health Insurance And Consumer Protections They Have Relied On For Years. .............................................................. 11 A. The ACA protects older adults against insurance discrimination based on age or health status. ............ 12 B. The ACA increases older adults’ access to health insurance in the individual market through the ACA marketplaces, tax credits, and subsidies ....................................... 17 ii C. The ACA provides life-saving health coverage to low-income older adults by expanding eligibility for Medicaid. ....................... 22 III. Invalidating The ACA Will Upend The Financial Stability Of The Medicare Program And Eliminate Many Protections for Medicare Beneficiaries ......... 25 A. The ACA strengthens the long- term financial stability of the Medicare program. .............................. 27 1. The ACA provides greater continuity of coverage, resulting in saving Medicare money because people are healthier by the time they enroll in the program. .............. 28 2. The ACA improves value, quality, and efficiency in Medicare. .................................. 30 B. The ACA includes critical coverage improvements for Medicare beneficiaries, enhancing access to care and affordability .......................... 32 IV. Invalidating The ACA Will Harm Older Adults Who Want To Age In The Community. .................................................... 35 iii V. Invalidating The ACA Would Put Older Adults At Greater Risk of Discrimination, Abuse, And Neglect And Make It Harder To Enforce Their Civil Rights. ...................... 37 A. The ACA empowers older adults to challenge discrimination in health care. .......................................... 38 B. The ACA provides quality and safety improvements for nursing facility residents and protects all older adults from abuse and neglect .................................................. 40 CONCLUSION ......................................................... 42 iv TABLE OF AUTHORITIES Cases Nat’l Fed’n of Indep. Bus. v. Sebelius, 567 U.S. 519 (2012) ............................ 11, 22, 23 Olmstead v. L.C. ex rel. Zimring, 527 U.S. 581 (1999) ........................................ 36 Statutes and Regulations 26 U.S.C. § 36B(b)(3)(A) ............................... 12, 17, 20 42 U.S.C. § 300gg(a)(1)(A)(iii) .................................. 14 42 U.S.C. § 300gg-1. ................................................. 12 42 U.S.C. § 300gg-4. ................................................. 13 42 U.S.C. § 300gg-6 .................................................. 15 42 U.S.C. § 300gg-11 ................................................ 13 42 U.S.C. § 300gg-12 ................................................ 13 42 U.S.C. § 1305 ...................................................... 41 42 U.S.C. § 1315a ..................................................... 30 42 U.S.C. § 1315b(a) ................................................. 34 42 U.S.C. § 1320a-7 .................................................. 40 42 U.S.C. § 1395c. ..................................................... 29 42 U.S.C. § 1395l(a)(1)(T) ......................................... 33 42 U.S.C. § 1395w-22(a)(1)(B)(iv). ........................... 34 42 U.S.C. § 1395w-102 ....................................... 32, 33 42 U.S.C. § 1396-1. ................................................... 22 42 U.S.C. § 1396a(a)(10)(A)(i)(VIII) ......................... 22 42 U.S.C. § 1396d(y) ................................................. 23 42 U.S.C. § 1396n ............................................... 36, 37 42 U.S.C. § 1396n(k) ................................................. 36 v 42 U.S.C. § 18022 ..................................................... 15 42 U.S.C. § 18031(b) ........................................... 12, 17 42 U.S.C. § 18071(c)(2). ...................................... 12, 17 42 U.S.C. § 18091(2) ................................................. 11 42 U.S.C. § 18116 ...................................................... 38 21st Century Cures Act, Pub. L. 114-255, § 17006(a), 130 Stat. 1033 (2016) .................. 34 Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 119 (2010) ...... 5 45 C.F.R. § 155.420(d) .............................................. 19 Legislative History 163 CONG. REC. H2406-7 (daily ed. March 24, 2017) ........................ 21, 22 H.R. Rep. No. 111-443 (2010) ...................................... 6 Other Authorities AARP Pub. Policy Inst., Weakening Age Rating Protections Will Make Health Care Unaffordable For Older Adults (Jan. 2017), https://www.aarp.org/ content/dam/ aarp/ppi/2017-01/Age%20 Rating%20Infographic.pdf....... ...................... 14 vi Elizabeth Abbott et al., Implementing the Affordable Care Act’s Insurance Reforms: Consumer Recommendations for Regulators and Lawmakers, Nat’l Ass’n of Insur. Commissioners, (Aug. 2012), https://www.naic.org/ documents/committees_conliaison_ 1208_consumer_recs_aca.pdf. ......................... 6 Linda J. Blumberg et al., Age Rating Under Comprehensive Health Care Reform: Implications for Coverage, Costs, and Household Financial Burdens, Urban Inst. (Oct. 2019), https://www.urban.org/ research/publication/age-rating-under- comprehensive-health-care-reform. ............ 7, 8 Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds, 2018 Annual Report, https://www.cms.gov/ Research-Statistics-Data-and-Systems/ Statistics-Trends-and-Reports/Reports Trust Funds/Downloads/TR2018.pdf. ........... 26 Dena Bunis, Medicare “Doughnut Hole” Will Close in 2019, AARP (Feb. 2018), https://www.aarp.org/health/medicare- insurance/info-2018/part-d-donut-hole- closes-fd.html. ................................................ 10 vii Sukyung Chung et al., Medicare Annual Preventive Care Visits: Use Increased Among Fee-For-Service Patients, But Many Do Not Participate, Health Affairs, https://www.healthaffairs.org/ doi/full/10.1377/hlthaff.2014.0483 ................ 33 Sara R. Collins et al., Help on the Horizon: How the Recession Has Left Millions of Workers Without Health Insurance, and How Health Reform Will Bring Relief, The Commonwealth Fund (March 16, 2011) ................................................................. 9 Cong. Budget Office, Budgetary and Economic Effects of Repealing the Affordable Care Act (June 2015), http://www.cbo.gov/ sites/default/ files/114th-congress-2015- 2016/reports/50252-effectsofacarepeal.pdf. .. 28 Keziah Cook et al., Does Major Illness Cause Financial Catastrophe?, 45 Health Servs. Res. 418 (Apr. 2010) ........................... 10 Nicole Craffitz-Wortz, et al., Association of Medicaid Expansion with Opioid Overdose Mortality in the U.S., Am. Med. Ass’n.: JAMA Network Open (2020), https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC6991255/ ............................ 24 viii Ctrs. for Disease Ctrl. and Prev., Coronavirus Disease 2019 (COVID-19), People Who Are at Higher Risk for Severe Illness (last visited May 11, 2020), https:// www.cdc.gov/coronavirus/2019-ncov/ need-extra-precautions/groups-at-higher- risk.html. ....................................................... 6 Ctrs. for Medicare and Medicaid Servs., Enrollee Experiences in the Medicare- Medicaid Financial Alignment Initiative: Results through the 2017 CAHPS Surveys (Dec. 2017), https:// www.cms.gov/Medicare-Medicaid- Coordination/Medicare-and-Medicaid- Coordination/Medicare-Medicaid- Coordination-Office/Financial AlignmentInitiative/Downloads/ FAICAHPSResultsDec2017.pdf .................... 35 Ctrs. for Medicare and Medicaid Servs., Transition to Payroll-Based Journal (PBJ) Staffing Measures on the Nursing Home Compare tool on Medicare.gov and the Five Star Quality Rating System, QSO-18-17-NH, (Apr. 6, 2018), https://www.cms.gov/Medicare/ Provider-Enrollment-and-Certification/ SurveyCertificationGenInfo/Policy-and- Memos-to-States-and-Regions-Items/ QSO18-17-NH.html. ...................................... 40 ix Ctrs. for Medicare and Medicaid Servs., 2019 Shared Savings Program Fast Facts – As of July 1, 2019, https://www.cms.gov/
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