Advocacy for Patients in the Supreme Court

Connecticut-based Advocacy for Patients with Chronic Illness files “Friend of the Court” brief in the United States Supreme Court Health Reform Case

Stating that “universal guaranteed issue, community-rated insurance is the promise of equal access to health insurance and, thus, health care for the chronically ill,” Connecticut-based Advocacy for Patients with Chronic Illness has asked the United States Supreme Court to uphold the health reform law’s requirement that everybody purchase insurance because that requirement is essential to obtaining coverage of people with pre-existing conditions.

Jennifer Jaff, the group’s Executive Director, stated that the health reform law creates a three-legged stool that will guarantee people with chronic illnesses can purchase insurance.

First, the law requires coverage of people with pre-existing conditions. The brief states:

Requiring insurance coverage of people with pre-existing conditions arguably does more to advance the cause of people with largely invisible chronic illnesses than any other law, including the Americans with Disabilities Act. 42 U.S.C § 12010, et seq. Some of us who are disabled will regain our health and our ability to contribute to society by working and earning our way. Others of us will be rid of unimaginable suffering and fear. Nothing Congress is empowered to do would provide more critical legal protection to people with pre-existing conditions, including chronic illnesses.

To achieve this goal, though, Congress had to construct the second leg, requiring people to purchase insurance to ensure that there would be healthy people in the insurance “pool” to control the cost of insurance; as well as the third leg, the affordability provisions, including community rating and advance payment tax credits (subsidies), to ensure that the cost of purchasing insurance would not be more than Americans can afford.

Using stories of some of the real people who have approached Advocacy for Patients for help, the brief seeks to illustrate the harm to chronically ill Americans of not having accessible, affordable health insurance.

· a woman with hepatitis C and cirrhosis of the liver who was laid off from her job of fourteen years. Her insurance was terminated coincident with the termination of her employment, as is the norm. She had to get her weekly injection of interferon, but she had not yet received her COBRA notice and hence was not HIPAA eligible, and she had no way to cover the cost of this injection; the provider would not treat her without active insurance.

· a woman with a genetic illness that affects her blood’s clotting who has been unemployed for two years, and although she exhausted her COBRA benefits, she cannot afford her state’s guaranteed issue option, which would cost more than $1000 per month, and is no longer HIPAA eligible. She was rejected by Medicaid for having $30 too much in her bank account.

· a young man called because the local county hospital told him that he probably has Crohn’s disease, but he could not receive a definitive diagnosis – and, thus, treatment – without a colonoscopy, which he cannot afford.

· a woman with reflex sympathetic dystrophy (also known as complex regional pain syndrome) who was diagnosed after her insurance went into effect, but the insurer took the position that she had to wait a full year before any services for her pre-existing condition would be covered.

· another woman wrote for her friend whose husband lost his job and, thus, his insurance; her friend has lupus and cannot afford any health care, without which she will die.

“Health insurance reform is a civil rights issue for us,” says Jaff. “It marks the end to legal discrimination against people with chronic illnesses, who cannot buy insurance for any amount of money.” The brief strongly urges the Court to find that the law was well within Congress’s power to regulate insurance by requiring coverage of pre-existing conditions, and to execute laws necessary to exercise that power, including the requirement that everybody purchase insurance.

The brief was co-authored by Michael D. Lieder of Sprenger & Lang, PLLC, in Washington, DC. The full text of the brief can be found here. For further information, please contact Jennifer Jaff at (860) 674-1370.

P.S. - The Connecticut Mirror writes about the brief here. J