Dear Senate Leader McConnell and Leader Schumer:
Doctors for America (DFA) was founded in 2009 on the principle of “patients over politics” – that we, as physicians and medical trainees who are responsible for caring for millions of patients in this generation and the next across America each day, should be advocates in ensuring the interests of our patients are front and center. DFA is more than 18,000 physicians, medical students, and health advocates across all 50 states. They work in private practices, academic centers, community health centers, and government-run systems such as the Veteran's Affairs and the Indian Health Services and are spread between delivery of primary and subspecialty care.Our vision is to build a robust and sustainable national grassroots movement of physicians and medical trainees dedicated to advocacy that improves the health of the nation.
We focus primarily on the issues of accessibility, affordability, and quality of health care; advocating for policies that advance public health; and alleviating inequities that compromise the abilities of some of our most vulnerable patients to access care. Over our nine-year history, DFA has initiated issue-based working groups focusing on a wide range of public health issues, ranging from gun violence prevention to food insecurity,substance use to women’s health, drug pricing and affordability to health system reform. Driven by pragmatic idealism, DFA is bringing the voice of physicians to communities across the country and to the national stage. We use the strength of our diverse backgrounds, our common vision, and a deep care for the patients and communities we serve to influence policy conversations at the national, state, and local levels.
Historically, DFA has not taken a position on Supreme Court nominations. However, the environment in which we currently live is anything but normal. We feel compelled as medical professionals to speak out when we feel the well-being of our patients is under threat, and the nomination of Brett Kavanaugh presents such a monumental risk to our patients. The gains in health care access and health outcomes that have been achievedthrough the implementation of the Affordable Care Act have had a dramatic positive impact – and make no mistake, the effects of expansion of insurance coverage to tens of millions of Americans are real for the patients we see each day. - and We have worked tirelessly over the last years to secure advances on countless public health issues in our country. All of these gains stand to be overturned – wrongly, we believe, both legally and morally – were Mr. Kavanaugh to be confirmed to the Supreme Court.
As DFA physicians, we always place our patients over politics. Returning to an era of discrimination based on pre-existing conditions; overturning the gains made by the ACA; gutting the freedoms, resources and, protections that women rely on for their health; ; eliminating efforts at gun violence prevention; de-regulating clean air and other anti-pollution initiatives; and dismantling clean water safe guards all will do dramatic damage to the health of our patients and our ability to care for them. Additionally, by gutting safeguards of voting rights, by opposing initiatives created to ensure our patients are able to exercise their voice in who represents their interests, and by asserting executive authority to circumvent accountability and government transparency, this nomination threatens to disenfranchise millions of our patients, weakening their abilities to ensure that their interests are represented in our democracy. With these protections diluted, our patients will not be able to protect themselves from these changes and the harm they may cause. This, in our minds, is completely unacceptable!
As you well know, the politics that now have engulfed the Supreme Court involve strategic political lawsuits all designed to weave themselves together through targeted legal maneuvers explicitly constructed to undermine the foundation of the American health care system. These lawsuits are cynical, unnecessarily retributive, and callous to the real human impact they may have. Decisions in these cases that Mr. Kavanaugh’s nomination is likely to sway will adversely affect the health and welfare of hundreds of millions of Americans, in the cruelest and most inhumane ways, all for political gain.
Our friends within the health care justice community have stated it well, which DFA 100% supports:
• Constitutionality of the Affordable Care Act, including protections for people with pre-existing health care conditions, is under constant attack. In one suit currently before the federal courts, Texas v. Azar,the State of Texas and co-plaintiffs cynically argue that the Affordable Care Act is unconstitutional because the individual mandate to purchase health insurance is no longer being enforced – a circular argument based on a vindictive decision made by members of their own party in the Executive Branch to not enforce or severely undermine the law. The Trump Administration has sided with the plaintiffs, choosing not to defend the law despite their constitutional obligation to do so, while arguing that protections for people with pre-existing conditions must be vacated. A decision to overturn the ACA in whole or in part would have devastating impacts for millions of people, threatening coverage for millions, including children with “preexisting” conditions at birth, pregnant women, people with life-threatening conditions such as cancer, as well as our elderly patients who suffer a range of chronic illnesses such as Alzheimer’s Disease, diabetes, and heart disease.
• Women’s access to critical health care services, including contraception, is under threat. The Supreme Court may be asked to rule on the constitutionality of federal and state laws that limit women’s access to providers and common contraceptives. It is well-established that expanded access to reproductive health care services including contraception reduces maternal mortality – thus, this lawsuit is an existential threat to millions of American women.
• Another series of lawsuits asserts federal authority to roll back health coverage for low-income people through Medicaid using “Demonstration Waiver” authority. In June, a federal judge ruled that the federal government's decision to approve Kentucky's waiver making dramatic cuts to Medicaid was unjustified under federal law because of its likely impact driving people off the program for failing to complete necessary forms. More than a dozen other states either have implemented or are seeking to implement similar policies. The Supreme Court is likely to take up this issue in the coming years. It goes without saying that these cuts and cruel reductions in access risk the health of hundreds of thousands of the Americans for whom you are sworn to advocate.
• The abilities of consumers, providers, and other stakeholders to hold state Medicaid programs accountable in federal court for violating federal Medicaid requirements might be gutted. The Supreme Court has previously ruled on this issue but may be asked to review it again as the Trump administration has proposed to further cut back federal oversight of rates and access in Medicaid.
On behalf of the millions of patients that we serve, we will be amplifying our voices as physicians throughout our country in our opposition to the nomination of Mr. Kavanaugh to the Supreme Court. . It is unconscionable that cynical political calculations are held paramount to the health and welfare of hundreds of millions of our patients. We will fight to protect our democratic values, the values that made our country great, and the U.S. Constitution from political ideology. We hope that we can count you as allies in that fight.