Despite once-in-a-generation challenges caused by the COVID-19 pandemic, the Trump administration and 18 states are still asking the US Supreme Court to rule that the Affordable Care Act (ACA) is unconstitutional and entirely repeal the decade old health law. Kids Forward joined with Harvard’s Center for Law and Policy Innovation and more than 100 other organizations to ask the US Justice Department and state officials to withdraw their lawsuit that threatens the ACA.
States across the country are grappling with unprecedented health care crises, economic downturns, and widespread surges in unemployment leading to millions losing their health insurance. We blogged about the vulnerabilities our reliance on job-based coverage creates, especially during extensive unemployment. While not going nearly far enough, the Affordable Care Act and BadgerCare offer some critical bandaging and viable options for many people. We released a fact sheet summarizing health insurance options for people losing coverage.
The Supreme Court is set to review the case, California v. Texas, later this year. The US Department of Justice and state attorneys general are asking the Court to strike down the entire law. Should the plaintiffs win, the Affordable Care Act would in effect be repealed without anything to replace it. That would only worsen the pandemic—and leave millions more without coverage during a sweeping health crisis that has already killed more than 68,000 people across the nation.
It is clear that the Affordable Care Act’s coverage gains and consumer protections are crucial. Without the ACA in place, 22 million more people would not have access to health insurance, millions of parents would be worrying about health coverage for their adult children, and tens of millions with pre-existing health conditions might not have the coverage they need. Further, much of the coverage loss would inequitably impact Black and Latinx residents, who were able to get health insurance through the ACA. Wisconsin and the rest of the country would be in a far more precarious situation without the health care reform law.
Even with the ACA, more than a hundred thousand people in Wisconsin will likely become uninsured due to job loss. According to a Robert Wood Johnson Foundation study conducted by the Urban Institute, between 350,000 and a million Wisconsinites could lose their employer-sponsored health insurance, depending on the level of unemployment in our state and estimations of the impact that will have on employer-sponsored coverage. Many of those losing coverage will qualify for BadgerCare, and many of the adults with family incomes above the poverty level will enroll in an ACA Marketplace plan. The study estimates that the number of Wisconsinites covered in the Marketplace – currently about 195,000 – will jump by at least 50% and possibly as much as 150% or 289,000.
A court ruling striking down the ACA would not only impact people insured through the ACA Marketplace but would also affect people who have insurance through their employers. It would take us back to the bad old days when even if you had employer-sponsored coverage, they could bar coverage for treatment of “pre-existing conditions” for a year or more. It would also bring back “job lock,” where people were forced to stay in jobs for fear that their health conditions might not be covered if they switched jobs or started a business.
Eliminating the ACA now would be catastrophic. We cannot risk destabilizing our already-strained, patchwork health care system by destroying a law that is deeply entrenched in almost all aspects of health systems and the lives of millions of families. Under normal circumstances, access to affordable, effective health care can mean the difference between life and death. Now health coverage is more important than ever. Everyone needs to be able to get testing and treatment for COVID-19 and have access to necessary routine medical care. The federal government should be working hard to make sure everyone everywhere has coverage, not asking the US Supreme Court to endanger the lives of millions by tearing up the Affordable Care Act. Wisconsin and the rest of the nation have so much as stake.
William Parke-Sutherland