On May 12, 2011, O. Marion Burton, President of the American Academy of Pediatrics, stated his support for the Affordable Care Act (ACA) amid legal challenges surrounding its requirement that most Americans buy health insurance by 2014. That week, the U.S. Court of Appeals for the 4th Circuit in Richmond, VA, heard oral arguments on two cases; the coverage mandate was found unconstitutional by one judge and upheld by another. "Health insurance works best when everyone participates: people contribute when they're healthy, so when they're sick, insurance takes care of them. Requiring everyone to purchase health insurance balances the scale," Burton stated. Burton also emphasized that the ACA provides important protection to children and adults by banning denial of coverage because of a pre-existing condition.