On August 7, 2020, a Manatt, Phelps & Phillips, LLP team that includes Michael Kolber, Joseph Laska and Joanna McCallum filed an amicus brief in the U.S. Court of Appeals for the Ninth Circuit on behalf of the California Association of Health Plans and the Association of California Life and Health Insurance Companies in Schmitt v. Kaiser Foundation Health Plan, Inc., et al. The team’s brief argues in support of Kaiser’s petition for a rehearing en banc by the full Ninth Circuit.

The case concerns disability discrimination under Section 1557 of the Affordable Care Act (ACA). The plaintiff claims that coverage exclusions for certain medical devices and services used to treat hearing loss constitute disability discrimination. The U.S. District Court for the Western District of Washington dismissed the suit but, in July 2020, a Ninth Circuit panel reversed in part.

The panel held that a court could find actionable disability discrimination under the ACA based on coverage benefit design decisions. The panel opinion, if not altered on rehearing, could have broad implications for how health plans throughout the western United States design and price their benefit packages.

The amicus brief explains the wide-ranging implications of the panel opinion and identifies significant factual and legal errors in the panel’s interpretation of the ACA. Over the first decade of the ACA, Manatt’s health group has been the premier law and consulting practice on ACA-related litigation, regulatory and public policy matters.

To read the full amicus brief, click here.