The high cost of treating COVID-19, its long-term health complications for those who recover, and the economic ramifications of the pandemic are driving home the value of the protections created under the Affordable Care Act – and how much trouble many Americans will find themselves in if the law is overturned.
A week after the presidential election, the U.S. Supreme Court is expected to hear arguments in a lawsuit brought by Texas and a group of Republican attorneys general that seeks to get rid of the Obama-era health-care law. An opinion is expected to be handed down next year.
If the court decides that the ACA should be tossed, more than 20 million people would lose health insurance they gained through the federal healthcare.gov, a state-based ACA marketplace, or Medicaid expansion.
Many more people, even some who get it through an employer, would be affected by the reversal of one of the law’s most popular insurance rules: protections for people with preexisting conditions. More than one in four people have a medical condition that, before the ACA, would have made them uninsurable.
“Insurance coverage is a little bit like a game of musical chairs,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation who studies health reform and private insurance. “With the ACA reforms, there was a much higher likelihood that if you lost your job, there would be another chair for you.”
Before the Affordable Care Act, insurers selling individual health plans were allowed to deny coverage entirely, exclude coverage for certain medical problems (or body parts), or charge higher rates for “riders” to a policy that would cover a person’s preexisting condition.
For instance, in one study of pre-ACA individual health plans, Pollitz found that insurers were willing to sell health insurance