The Eleventh U.S. Circuit Court of Appeals is hearing oral arguments today regarding the constitutionality of the Patient Protection and Affordable Care Act (ACA), the third federal appellate court to do so. With at least 20 cases involving federal district courts in 15 different states, the legal challenge brought by the State of Florida and 25 other states argued before a panel of three judges in Atlanta today is the most watched of all of the ACA cases. At issue in the cases allowed to proceed past the dismissal stage, including Florida’s, is the “individual mandate” which requires individuals to maintain minimum health insurance coverage or pay a penalty.

Amidst the legal arguments, it is important not to lose sight of what the ACA means to real people – and, of particular concern to the National Women’s Law Center (NWLC), to women. One of the important purposes of the ACA was to put an end to the gender rating practices so common throughout the insurance industry which increases the costs of health insurance premiums for individual women and small businesses with predominately female workforces. Women stand to lose profound economic benefit if the ACA is struck down. The NWLC filed an Amicus Brief in response to the State of Florida’s challenge to the ACA, making these arguments (in a lot more detail, if you would like to read). Let’s hope the Eleventh Circuit takes the ACA’s impact on women into account, when rendering its decision in the next few months.  

The ACA regulates the longstanding practice by insurance companies of charging women more for insurance coverage based solely on their gender as well as the denial of coverage for essential services such as maternity care. The ACA prohibits insurers’ widespread practice of charging women higher premiums than men of the same age. Besides economic benefits, the ACA explicitly targets insurance industry practices that discriminate against or disadvantage women. The ACA requires insurers to provide coverage to women they previously denied benefits because of “pre-existing conditions” such as having given birth through previous Caesarean section, being pregnant at the time they seek coverage, having survived domestic violence and received treatment related to abuse, and received medical treatment after sexual assault. In essence, insurance companies have been accused of treating woman, due to their gender, as a pre-existing condition. These practices have an enormous impact on women’s health, pocketbooks, and general well-being. The ACA provides for women what previous insurance carriers did not, i.e., assurance that pre-existing medical conditions inherently exclusive to women will not prevent women from obtaining health insurance coverage.

Currently, two additional oral arguments are scheduled to take place this year before the Ninth Circuit Court of Appeals in July and the D.C. Circuit Court of Appeals in September. In all of these cases, the plaintiffs’ main argument is that the “individual mandate” violates Congress’ authority provided to it by the Constitution through its Commerce and Taxing Clauses. The NWLC is optimistic that the Eleventh U.S. Circuit Court of Appeals will follow the more recent court of appeals cases recognizing that the Commerce Clause is a source of authority for Congress to address civil rights, which may include the economic impact of gender discrimination. The ACA addresses the persistent discrimination and inequality in pursuit of a moral and social ideal that women will realize; presuming the panel of judges listening to the oral arguments today reverses the district court’s decision.