The Center for Medicare Advocacy recently filed amicus curiae (“friend of the court”) briefs in several cases that may have a significant impact on the health care of older adults and people with disabilities.
- Last week, the Center led a coalition of organizations that urged a federal court in Iowa to allow new nursing home staffing requirements to take effect. Twenty states and 21 non-profit nursing home industry groups challenged the Biden’s administration’s minimum staffing standards in October 2024. State of Kansas v. Becerra, 1:24-cv-00110 (N.D. Iowa). They now seek a preliminary injunction that would pause implementation of the staffing rule nationwide while the litigation continues. The amicus coalition comprises organizations that represent the interests of nursing facility residents, including the Center, the National Consumer Voice for Quality Long-Term Care, Justice in Aging, and the Long Term Care Community Coalition. Their amicus brief opposes the plaintiffs’ request to block the staffing rule. The court held a hearing on whether to issue the injunction on December 5, 2024. The judge took the matter under advisement and is expected to issue a decision soon.
The amicus brief explains the dire consequences to residents of inadequately staffed nursing facilities, and supports the implementation of the first-ever national minimum staffing requirements. The brief features the voices of family members and staff who submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the critical need for adequate staffing standards. They described the horrific circumstances faced by residents in poorly-staffed facilities, such as lying for hours in urine and feces, the development of bedsores and wounds due to lack of care, and death from missed care. The brief also highlights studies showing that adequate staffing is essential to ensuring residents’ health, safety, welfare, and rights, and that the staffing rule is projected to save approximately 13,000 lives per year. The brief undermines the plaintiff states’ and industry groups’ arguments that facilities cannot afford to implement the staffing standards. It points out that many nursing homes are already in compliance with components of the staffing rule. Moreover, facilities are not currently using the public money they receive from Medicare and Medicaid efficiently or effectively. Rather, nursing homes divert significant amounts of their revenue to “related” entities that benefit their own owners and operators, and spend only 27% of their revenue on actual nursing.
Two other cases challenging the staffing rule have been consolidated and are pending in Texas, but the plaintiffs did not seek preliminary injunctions in those cases. American Health Care Ass’n v. Becerra, 2:24-cv-00114 (N.D. Tex.); State of Texas v. U.S. Dep’t of Health & Human Servs., 2:24-cv-00171 (N.D. Tex.). The Center joined an amicus brief filed by AARP that supports the staffing rule in those cases as well. The future of all of the cases is unknown, because the incoming Trump administration may decline to defend the staffing rule in court or may issue new regulations that revoke the staffing standards. Legislation pending in Congress could also repeal or delay implementation of the staffing rule.
- The Center is grateful to RSH Legal for their pro bono assistance in State of Kansas v. Becerra.
- Read the amicus brief.
- Read the Des Moines Register article about the amicus brief and the case.
- The Center continues to support the Medicare prescription drug price negotiation program in amicus briefs filed by an AARP-led coalition of beneficiary advocates. The Inflation Reduction Act of 2022 empowered Medicare to directly negotiate prices for certain high-cost drugs. Drug manufacturers and their allies have filed several lawsuits challenging the negotiation program and requesting that it be struck down. The beneficiary advocates’ amicus briefs explain that drug price negotiation is urgently needed because it will help older adults and disabled people afford life-saving medications, protect the financial integrity of Medicare, and save taxpayers billions of dollars. The first round of negotiations for 10 Part D drugs concluded in August 2024. When the negotiated prices take effect in 2026, along with other cost-savings provisions of the Inflation Reduction Act, CMS projects that Part D enrollees will save an estimated $1.5 billion. Medicare is scheduled to announce up to 15 Part D drugs for the second round of negotiations by February 1, 2025.
So far, the drug companies have not prevailed on any of their central legal challenges to the negotiation program in the nine lawsuits that remain pending. Yet the fate of the litigation is uncertain as these cases reach appellate courts, and the position of the incoming Trump administration on drug price negotiation is unknown.
Read examples of the drug price negotiation amicus briefs here, here, and here.
- The Center recently joined Justice in Aging and SAGE in submitting amicus briefs in cases that could erode the Affordable Care Act’s protections against discrimination and exacerbate the challenges LGBTQ+ people face in accessing needed health care. Section 1557 of the Affordable Care Act is a landmark provision that prohibits discrimination in health care on the basis of age, disability, sex, national origin, race, or color. Several states have challenged Section 1557 regulations that define “on the basis of sex” to include protections on the basis of sexual orientation and gender identity. The plaintiff states, including Tennessee and Texas, have obtained injunctions against the enforcement of certain portions of Section 1557 while the litigation proceeds, including a nationwide injunction against provisions that protect transgender individuals.
The amicus briefs argue that these injunctions should be vacated, and they highlight the harm transgender older adults face when attempting to access health care. Transgender older adults experience significant discrimination in health care, and this can lead to poor health outcomes. Transgender older adults also depend on protections against discrimination when accessing long-term care services, including through the PACE or Medicaid programs. In general, they require access to gender-affirming, transgender-friendly health care. The briefs explain the particular health care discrimination challenges faced by transgender older adults and urge the courts to reinstate the protections of Section 1557.
Read the amicus briefs in State of Tennessee v. Becerra and State of Texas v. Becerra, which are both pending before the Fifth Circuit Court of Appeals.
December 12, 2024 – A. Bers