WASHINGTON—The first case challenging a state statute restricting the activities of consumer assistance organizations authorized by the Affordable Care Act---has been filed in federal district court in Jefferson City, Missouri. The case, entitled St. Louis Effort for AIDS v. Huff, was filed last week by consumer organizations that are certified under the ACA to provide assistance to help uninsured Missourians obtain health insurance, physicians, and private individuals.
The plaintiffs allege that the Missouri statute both prevents them from providing the assistance the ACA requires them to provide to consumers, and prevents consumers from obtaining such assistance. They ask that the court enjoin the statute and declare it unconstitutional. The plaintiffs in the case are St. Louis Effort for AIDS; Planned Parenthood of the St. Louis Region and Southwest Missouri; Consumers Council of Missouri; Missouri Jobs with Justice; Jeanette Mott Oxford; Dr. Wayne Letizia; Dr. William Fogarty; and Chris Worth.
"Missouri has placed groups like St. Louis Effort for AIDS in an untenable situation: If they comply with the Missouri statutes, they can't perform the duties the Affordable Care Act requires them to perform, but if they comply with the ACA and do perform those duties, they violate the Missouri law and are subject to thousands of dollars in penalties for doing so," said plaintiff's counsel Jay Angoff of Mehri & Skalet, a former Missouri Insurance Commissioner and head of ACA implementation at the HHS. "Those conflicts have created a culture of fear among the very people charged with helping Missourians comply with the new law."
"The ACA provides clear and controlling rules for the scope, role and duties of Navigators and other consumer assisters," said co-counsel Jane Perkins, legal director at the National Health Law Program (NHeLP). "Missouri's law goes the unnecessary step to block the ability of consumer assisters to serve their intended function under the ACA---which is to help consumers navigate the new Marketplace and get enrolled in a qualified health insurance plan. Missouri is not only contravening the federal law, it is undermining and chilling enrollment efforts throughout the state."
As stated in the complaint:
- The Missouri statute conflicts with the ACA, and prevents consumer assistance organizations from doing their jobs, because it prevents them from talking about the benefits, terms and features of health insurance plans. The complaint says these provisions violate the Supremacy Clause of the Constitution because they conflict with ACA provisions requiring consumer assistance organizations to provide impartial and timely information to consumers about all their health insurance options.
- The Missouri statute broadly requires private individuals and organizations that perform any service of a consumer assister---including discussing health insurance options--to be licensed by the Department. The complaint says that such a requirement is a restriction on speech that violates the First Amendment.
- The Missouri statute gives the Director of the Missouri Insurance Department the authority to penalize consumer assistance organizations not just for violating the state law but "for other good cause." The complaint says that this violates the Due Process Clause of the Constitution, because it does not give consumer assistance organizations notice of the conduct they can be penalized for.
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