You’ve probably heard a lot about the Affordable Care Act over the past decade, starting with the Obama administration and continuing until today. Of course, the context you hear about the ACA has drastically changed in recent years and even more in recent months, in light of the Covid-19 pandemic and 2020 presidential election.
Added to that, with the recent death of Supreme Court Justice Ruth Bader Ginsburg, the new appointment of conservative Justice Amy Coney Barrett, and the impending healthcare repeal lawsuit, the fate of the Affordable Care Act (ACA) is entirely uncertain. This is especially terrifying for the millions of people whose health and security depends on the care they receive under the program.
But what exactly does it all mean? What is the ACA? What would repealing the ACA do to this country? Perhaps, most notably, for millions of citizens, especially those with pre-existing conditions, how will repeal the ACA impact our ability to access healthcare in the coming years?
What is the Affordable Care Act?
The Affordable Care Act, otherwise known as Obamacare, is a United States federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama in March 2010. The health law has three primary goals: 1) to make affordable healthcare available to more people, 2) to expand Medicaid to cover all adults with income below 138% of the federal poverty level, and 3) to lower the costs of healthcare by supporting innovative medical care.
Generally speaking, the ACA is intended to expand access to insurance, increase consumer protections, emphasize prevention and wellness, improve quality and system performance, expand the health workforce, and curb rising health care costs, according to the National Conference of State Legislatures.
The Obama-era health law was designed to ensure that all Americans have access to affordable healthcare. It also made sure that insurance companies could not deny a person coverage if they had a pre-existing condition and could not jack up the cost of insurance to those simply because of past medical conditions.
It’s no secret that there are many pros and cons to this health law, and it is extremely divisive in terms of supporters and critics throughout the country. Today, ten years after the landmark health reform law was passed by Congress and signed into law by President Obama, the future of the ACA is in serious jeopardy.
Soon the Supreme Court will hear oral arguments in a case brought by the Trump Administration and a coalition of Republican state attorneys general, who argue that the health law should be invalidated. To say that repealing the ACA would have a sweeping and devastating impact on millions of Americans is a severe understatement. So, let’s look at the potential fallout and how it might affect you.
What Would Repealing the ACA Mean for People in America?
First of all, let’s just address the elephant in the room. Yes, President Trump and his administration are attempting to dismantle and abolish a healthcare law that protects the health of millions of Americans, in the middle of a global pandemic that has claimed more than 230,000 thousand lives and has infected more than 9 million people in this country at the time this article was written.
As House Speaker Nancy Pelosi said, “President Trump and the Republicans’ campaign to rip away the protections and benefits of the Affordable Care Act in the middle of the coronavirus crisis is an act of unfathomable cruelty.”
That’s because getting rid of Obamacare would mean that more than 20 million people would lose their health coverage, and more than 135 million people would lose protections for their preexisting conditions. And here’s the kicker — the millions of people who were able to overcome Covid-19 are now considered to have a pre-existing condition simply because they survived the pandemic that is devastating the world.
Speaking of pre-existing conditions, those Americans who have this kind of condition — tens of millions of people — would be at risk of losing their health insurance if the ACA is repealed.
Research from the Kaiser Family Foundation shows that in 2018 nearly 54 million American adults had pre-existing conditions that would make them unable to buy insurance, and a 2017 study from the Department of Health and Human Services estimated that 133 million people had pre-existing conditions that would make them unable to purchase insurance.
What is a pre-existing condition, you ask? It’s not only a chronic or fatal illness, and it doesn’t only apply to people with disabilities. Pre-existing conditions can also include common existing medical conditions, such as high blood pressure, diabetes, asthma, and even acne.
While President Trump has claimed that his administration plans to keep this provision to protect those with pre-existing conditions through a series of executive orders, they have not released any information on exactly how they would do that in the new proposed healthcare plan. Those tens of millions of people with a pre-existing condition are at risk of losing health insurance if the Supreme Court rules to repeal the ACA.
It’s important to note that repealing the ACA would do much more than just impact those individuals with pre-existing conditions. It would also affect access to preventative care, such as free mammograms, cholesterol checks, and birth control access. It would affect families who currently can keep their children on their health insurance plans until the age of 26 (a policy presently protected by the ACA).
Repealing the ACA would also impact Medicaid, the government insurance program for the poor that is jointly funded by the federal government and the states. Approximately 21 million Americans would be at risk of losing their insurance coverage. According to CNBC, the federal government pays 90% of the cost in states with expanded Medicaid. If Obamacare is repealed, then states would lose that federal funding. Without those funds, states would likely not have the necessary resources to continue Medicaid expansion, leaving millions without insurance coverage.
The hundreds of thousands of people receiving addiction treatment to help with substance abuse issues, including opioid addiction, might also be at risk of losing their coverage. The nearly 60 million people over the age of 65 who are covered under Medicare would also be impacted, potentially facing higher premiums and higher costs for preventative care such as wellness visits and free diabetes checks.
As the country (and the world) battles an unforgiving and unrelenting virus, millions of people rely on the Affordable Care Act’s security and care, especially when faced with unemployment and economic struggles due to the pandemic.
If the ACA is struck down, those Americans who have lost their jobs and their health insurance will be at risk of losing coverage at a time when people of all ages need medical care most.
There is much uncertainty surrounding Obamacare’s future. All eyes will be on both the presidential election and the upcoming Supreme Court case, both of which will determine the future of healthcare for millions of people in America.