WASHINGTON - The National Women’s Law Center has just filed a “friend of the court” brief on behalf of 31 organizations in Cuccinelli v. Sebelius, a case before the Fourth Circuit Court of Appeals, which is considering an appeal to a Virginia district court decision that a key provision of the Patient Protection and Affordable Care Act (ACA) is unconstitutional. The brief explains what’s at stake for women in the challenge to the new health care law and why the ACA, in correcting fundamental gender inequities in the health insurance and health care markets, is an appropriate exercise of federal Commerce Clause authority and therefore is constitutional.
In this case, as in other cases seeking to overturn the health care law, the primary constitutional challenge is to the personal responsibility provision, which requires individuals to obtain health insurance by 2014. “Our brief explains that the health care law, which has as one of its major purposes advancing women’s health and combating sex discrimination in the health insurance market, falls within Congress’s authority to regulate interstate commerce under the Constitution— like many federal laws that protect women from discrimination and disadvantage,” said Marcia Greenberger, Co-President of the National Women’s Law Center. “The personal responsibility provision, as part of the law’s effort to address failures in the health insurance market, is fully within Congress’s constitutional authority to enact.”
The brief explains that one of the primary purposes of the ACA was to improve women’s health and access to health insurance by eliminating many of the discriminatory practices that women have faced, including insurance denials based on “pre-existing conditions”—such as previously having been a victim of domestic violence—and gender rating, the practice of charging women more for coverage based solely on their sex. The law also contains many other provisions to make health care more accessible to women, such as the requirement that insurance companies cover maternity care as an essential benefit and that plans cover recommended preventive services and screenings such as Pap tests and mammograms at no additional cost to the individual.
The Supreme Court has long recognized that civil rights legislation designed to address discrimination and remove obstacles to women’s and minorities’ full participation in the economy is a constitutional exercise of congressional power under the Commerce Clause because of the significant impact that discrimination has on the broader economy. Given this legal backdrop, the brief asserts that the ACA’s purpose and effect of addressing barriers that women face in obtaining health insurance strengthen the conclusion that the legislation is constitutional.
“Throughout the congressional debate over health reform, a significant concern was the impact that the law would have on women,” said Emily Martin, Vice President and General Counsel of NWLC. “Congress wanted to ensure that being a woman would no longer be a preexisting condition. The personal responsibility provision makes it economically possible to prohibit insurers from denying coverage based on preexisting conditions, and as a result, addresses the financial impact of discrimination in a manner fully consistent with the Constitution.”
The National Women's Law Center is a non-profit organization that has been working since 1972 to advance and protect women's legal rights. The Center focuses on major policy areas of importance to women and their families including economic security, education, employment and health, with special attention given to the concerns of low-income women.