SACRAMENTO – California Attorney General Xavier Becerra, leading a coalition of 17 attorneys general, has filed a reply brief in Texas v. U.S., defending the Affordable Care Act and the healthcare of millions of Americans.
Attorney General Becerra’s brief argues that the ACA remains the law, and details the harm that ending the ACA will have on the U.S. health system, states, and millions of Americans.
“It’s hard to imagine a world in which millions of Americans could lose healthcare, but these are the stakes right now in federal court,” said Attorney General Becerra. “The Trump Administration shows little regard for Americans’ healthcare, lives, or the law. Every American could be affected by this case’s outcome: children, seniors, workers covered by employers or through the Marketplace, and the hundreds of millions of people with a pre-existing condition. This shouldn’t be a debate: the ACA is the law of the land, and we will continue to challenge this dangerous attempt to undermine Americans’ health.”
On Dec. 14, 2018, the Court issued an opinion in Texas v. U.S., ruling that the ACA was unconstitutional.
The decision lacked clarity. As a result, Attorney General Becerra filed an expedited motion to continue the legal defense and ensure that the ACA continues to be implemented and enforced nationwide.
The motion additionally requested that the court certify the opinion, so that it may be appealed to the Fifth Circuit Court of Appeals immediately.
According to briefs filed by Texas and the federal government, all of the parties agree that the court’s Dec. 14 order has no immediate effect, that the court should certify the order for immediate appeal in the Fifth Circuit and that proceedings in the district court should be stayed pending the outcome of that appeal.
Attorney General Becerra has requested that the court rule on the motion before Jan. 1, 2019.
An electronic copy of the brief can be found here.
BERKELEY, Calif. – Less-educated African American women who report experiencing high levels of racial discrimination may face greater risk of developing chronic diseases, says a new study by University of California, Berkeley, researchers.
The study of 208 middle-aged African American women from the San Francisco Bay Area is the first to examine the links between racial discrimination and allostatic load, a measure of chronic physiologic stress in the body that is a predictor of a variety of chronic diseases.
Higher levels of educational attainment may buffer some of the negative health effects of discrimination, the team found.
“Racial discrimination has many faces. It is not being able to hail a cab, getting poor service in stores and restaurants, being treated unfairly at work, being treated unfairly by police and law enforcement and being followed around in stores because of racial stereotypes,” said Amani M. Allen, an associate professor of epidemiology and community health sciences in UC Berkeley’s School of Public Health. “We found that experiencing racial discrimination repeatedly can create a state of biological imbalance that leaves certain groups of people more susceptible to chronic disease.”
Numerous studies show that African American women have higher levels of allostatic load, a collection of biological factors like high blood pressure and high blood sugar that collectively raise an individual’s risk of developing chronic illness.
African American women are also more likely than other racial and gender groups to experience chronic diseases, including heart disease, stroke, diabetes and cancer.
While previous research has linked racial discrimination to specific conditions, this study, appearing online this month in the journal Psychoneuroendocrinology, is the first to examine the association between racial discrimination and allostatic load.
“We know that African American women suffer disproportionately from chronic disease, and we know a lot about what contributes to these diseases – diet, physical activity, access to care and even genetics in some cases,” Allen said. “However, these factors fall short of explaining the disparities faced by African American women. The goal of our study was to examine whether racial discrimination is in itself a type of stressor that may be related to higher levels of allostatic load, thereby increasing risk of chronic illness among this group.”
Each participant completed a questionnaire rating their experiences of racial discrimination in different contexts, including finding housing, finding employment, at work, at school, getting credit for a bank loan or mortgage, and in healthcare settings. The team also gave each participant a physical exam, recording their height, weight, blood pressure, blood sugar and measures of inflammation and other health indicators that can contribute to allostatic load.
Study participants were provided with the results of their physical exams and given educational materials about health risks facing African American women. “It was important to us that this be an informative experience for them,” Allen said.
The team broke down the analysis by educational attainment and poverty status, unearthing some surprising trends. For African American women with a high school diploma or less, experiencing a high level of racial discrimination correlated with much higher allostatic load. However, this trend was reversed for highly educated women, for whom very high levels of racial discrimination correlated with lower allostatic load.
The researchers hypothesize that these differences may be partly attributed to how women interpret the racial discrimination they face.
“There are better health outcomes associated with those who attribute their racial discrimination experiences to systemic racism and do something about it as opposed to just accepting it and engaging in self-blame,” said Marilyn D. Thomas, a doctoral candidate in epidemiology at Berkeley. “Since we found that less-educated women were less likely to report racial discrimination, we suspect that those who have higher education may be more prepared to acknowledge and report racism versus internalizing it and blaming themselves.”
While the relationship between racial discrimination and allostatic load also varied by poverty status, the trends were not as pronounced as they were for education level.
The researchers stress that while education is a powerful predictor of health, it should not be seen as an antidote to the potential adverse health effects of racial discrimination.
“We need to think about the determinants of health in different ways,” Allen said. “They are not just access to care, genetics or even socioeconomic position. We need to look at the social conditions of people’s day-to-day lives, and how we might improve those conditions so that every person, regardless of their race, their gender or anything else, has an equitable opportunity to live optimally. Unequal treatment is bad for health.”
Other authors include Eli K. Michaels, Alexis N. Reeves and S. Leonard Syme of the division of epidemiology at UC Berkeley; Uche Okoye and Melisa M. Price of the division of community health sciences at UC Berkeley; Rebecca E. Hasson of the school of kinesiology and public health at the University of Michigan; and David H. Chae of the department of human development and family studies at Auburn University.
This work was supported by research grants from the University of California, Berkeley (UCB) Hellman Fund, UCB Population Center, UCB Research Bridging Grant, UCB Experimental Social Science Laboratory, Robert Wood Johnson Health and Society Scholars Program (UCB site), UC Center for New Racial Studies, and UCB Institute for the Study of Societal Issues, National Institute of Minority Health and Health Disparities grant P60MD006902 and National Institute of General Medicine Science grant UL1GM118985.
SACRAMENTO – California Attorney General Xavier Becerra filed an amended complaint and a motion for preliminary injunction in federal court in State of California, et al v. Alex Azar, II, et al.
The filing moves to block the Trump Administration’s new final rules that would deny millions of women and their families access to cost-free birth control by allowing employers to interfere with their healthcare decisions.
The final rules, which are set to go into effect on January 14, 2019, would jeopardize the Affordable Care Act’s requirement that employers provide coverage of all 18 FDA-approved birth control methods and counseling for employees and their covered dependents with no out-of-pocket costs.
To date, 62 million women across the country have benefited from these reproductive health services, including over seven million in California.
“We successfully fought the Trump Administration’s interim final rules because employers have no business interfering in women’s healthcare decisions. But the Trump Administration is continuing to trample on women’s rights and access to care with this illegal final rule,” said Attorney General Becerra. “Women across the country have benefitted from the ACA’s cost-free birth control. California will continue the fight against any actions that attempt to restrict women’s access to affordable, quality healthcare.”
Attorney General Becerra filed the amended complaint and motion for preliminary injunction in the U.S. District Court for the Northern District of California.
This action builds on Attorney General Becerra’s successful opposition to the Trump Administration’s interim final rules.
On Dec. 21, 2017, California secured a nationwide preliminary injunction halting the implementation of the interim final rules.
On Dec. 13, 2018, the U.S. Court of Appeals for the Ninth Circuit upheld the lower court’s ruling.
In filing the amended complaint and motion for preliminary injunction, Attorney General Becerra is joined by the Attorneys General of Connecticut, Delaware, Hawai’i, Illinois, Maryland, Minnesota, New York, North Carolina, Rhode Island, Vermont, Virginia, Washington and the District of Columbia.
SACRAMENTO — California Attorney General Xavier Becerra on Monday led a coalition of 17 attorneys general in filing an expedited motion to prevent disruption to Americans’ health care and to challenge Friday’s opinion in Texas v. US, which ruled that that the Affordable Care Act, or ACA, was unconstitutional.
Monday’s motion seeks clarification on the impact of Friday’s decision and requests that the judge prevent any confusion about the opinion.
The motion requests the court to make clear that the ACA is still the law of the land and will continue to be enforced and implemented by states, the federal government, and entities across the country until an order by the court expressly states otherwise.
While the California-led multistate coalition maintains the position that the ACA is the law of the land, Friday’s opinion has caused uncertainty in the nation’s health care system that could harm people across the country.
“The District Court’s ruling poses a dangerous threat to the healthcare of millions of Americans. We’re asking the court to make clear that the ACA is still the law and ensure that all Americans can continue to access affordable healthcare under it,” said Attorney General Becerra. “Today’s filing makes clear that California and its partner states will do everything possible to challenge this reckless ruling that threatens the healthcare of Americans from California to Maine, risking the health of seniors, children, workers and young adults in every state in the nation. Our coalition will continue to fight to preserve access to healthcare, which is critical to the strength of our nation.”
Monday’s filing is a critical step in challenging Friday’s opinion. It requests that the Court provide clarity on its opinion and confirm that it does not change the status quo.
Finally, Attorney General Becerra has asked the court to grant an immediate stay that requires the federal government, states and all entities to continue enforcing and implementing the ACA or, alternately, to certify the opinion, so that it may be appealed to the Fifth Circuit Court of Appeals immediately.