The Pennsylvania Supreme Court will decide whether Philadelphia can continue to collect a sugary-drink distribution tax—a levy that the AMA and others are urging justices to keep in place because it is a positive tool to help curb the obesity epidemic that is a major contributor to heart disease and type 2 diabetes.

Two lower Pennsylvania courts previously ruled that Philadelphia officials can levy a 1.5-cent per fluid ounce tax on sugar-sweetened beverages from distributors. The law, enacted in 2016, includes any drink with a sugar-based sweetener or artificial sugar substitute. The measure excludes products that contain more than 50 percent milk, fresh fruit or vegetables and some unsweetened drinks to which sugar is added later.

A coalition of retailers and retail groups that brought the lawsuit is appealing the Pennsylvania Commonwealth Court’s decision in Williams et al. v City of Philadelphia to the Pennsylvania Supreme Court, asking those justices to rule that the levy is duplicative of the general retail sales tax and, therefore, not allowed.

The Litigation Center of the American Medical Association and State Medical Societies, as it did in the lower court cases, recently filed an amicus brief supporting the sugary-drink tax.

More than a dozen organizations—including the American Heart Association and Pennsylvania Medical Society—joined the Litigation Center in the brief that attempts to rebut the legal argument that the tax is duplicative and explains to the court why the tax is important to the public’s health.

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The brief outlines the scientific evidence that links sugar-sweetened beverages (SSBs) to increased risks for heart disease, type 2 diabetes, obesity, tooth decay and other health problems that Philadelphia residents and Americans from coast to coast are battling. Nearly 68 percent of adults and about 41 percent of 6- to 17-year-olds in Philadelphia are overweight or obese, according to the Centers for Disease Control and Prevention.

“The disability, suffering and premature death associated with the overconsumption of SSBs touches Philadelphia’s families and reduces the vibrancy of the community as a whole,” the brief states. “A tax on distributing a product into the City that leads to so much harm helps the city mitigate these negative externalities and provide for the public good.”

AMA policy encourages “state and local medical societies to support the adoption of state and local excise taxes on sugar-sweetened beverages with the investment of the resulting revenue in public health programs to combat obesity.” And the AMA provides doctors with tools to help prevent heart disease and prevent diabetes.

In the brief, the AMA’s Litigation Center acknowledges that SSBs are not the only culprits in the obesity epidemic, but underscores that “there is still reason to be particularly concerned with the outsized role that SSBs play in harming public health.”

The brief cites research showing that sweetened beverage intake has a stronger association with excess weight that any other single food or beverage. Other researchers found that drinking just one SSB a day is associated with an 80 percent increased risk for women of developing diabetes and a 55 percent increased risk of obesity for children, the brief notes.

Impact on other health initiatives

In addition to contending that the tax is duplicative, the groups challenging the levy say it should be done away with because it generally—and indirectly—interferes with the state’s ability to control taxation and raise revenue. They say it will increase what the consumer pays for the affected beverages, lead to fewer sales and ultimately result in the state collecting less money through state tax.

If the court adopts the industry’s legal arguments, the AMA and other amici say the city’s “ability to govern for the public’s health and welfare” would be “thwarted” because it would also invalidate other measures the city has taken to curb residents from consuming unhealthy products, including SSBs.

For example, the Philadelphia school district forbids the sale of sugary beverages in schools and limits availability in public vending machines. The city also provides financial incentives for corner stores to highlight healthy foods, including signs that suggest drinking water and remind customers how much exercise takes to burn the calories in a can of soda. The city sends educators into public schools to teach kids about nutrition and the city has one of the nation’s strictest menu labeling-laws.

“Undoubtedly, all these measures are designed to deter purchases of SSBs—and reports already show they are working,” the AMA Litigation Center and others argue in the brief. “Under the plaintiffs’ and their amici’s view, all these measures would be barred … such a result would be absurd. No court has adopted such a sprawling argument that would hamstring basic public health measures. The court should not adopt it here.”


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