If the Affordable Care Act (ACA) is repealed, almost every American will feel the effects in some way, according to analysis by the Kaiser Family Foundation. The U.S. Supreme Court is due to rule on a case contested the ACA just a week after the 2020 presidential election on November 3.
The Trump administration supports the lawsuit filed by several Republican officials in 2017 and wants the court to completely invalidate the domestic policy signed by Home Secretary Barack Obama.
The success of the lawsuit has been viewed as far-reaching, according to news website Axios. But that was before Associate Justice Ruth Bader Ginsburg's death on September 18. It is possible that the case will be heard by a new Associate Justice appointed by President Donald Trump to fill her seat in court.
Incorporated into law in 2010
The ACA, also known as Obamacare, was incorporated into law in 2010. He created a private market for health insurance with tiered grants and extended Medicaid eligibility.
According to the Kaiser Foundation, 10.7 million people received health insurance coverage in February 2020 through insurance markets established as part of the ACA. Of these people, 9.2 million will receive tax credits while 5.3 million will receive a cost sharing reduction.
However, the ACA was challenged in court almost immediately after it went into effect.
In 2012, the Supreme Court overturned the mandate that most citizens and lawful residents are required to have health insurance. Chief Justice John Roberts joined the court's four Liberal Justices to save the rest of the ACA.
In 2017, several attorneys general filed the current case, saying that without the insurance mandate, the rest of the law should fall. A federal appeals court upheld the lawsuit in late 2019 and set the stage for the November showdown in the Supreme Court.
From 2010 to 2016, the number of uninsured Americans fell by 20 million, according to Kaiser. Since then, the number of uninsured has increased by 2.3 million.
Approximately 12 million Medicaid recipients in 33 states and the District of Columbia were eligible through extended Medicaid eligibility as of June 2019, Kaiser reported. That includes 3.7 million in California and at least half a million each in Pennsylvania, Michigan, Illinois, Washington, Ohio, and New Jersey.
Existing conditions covered
Insurers are not allowed to deny coverage or charge higher premiums based on health or gender to an estimated 54 million Americans with pre-existing conditions. Kaiser noted that many of these people may not have found insurance from ACA because of their pre-existing conditions. This would affect one-third of residents in states like Alabama, Arkansas, Kentucky, Louisiana, Mississippi, and West Virginia.
The law also doesn't allow insurers to withdraw coverage if someone becomes sick, nor can they set annual or lifelong coverage limits. In addition, private insurers must cover a wide range of prevention services for free, including recommended checkups and vaccinations for cancer and chronic diseases. The same benefits are typically covered for the 150 million Americans who are enrolled on employer plans or through individual market insurance, Kaiser said.
The ACA has enabled 2.3 million young adults to receive insurance through their parents' plans up to the age of 26.
The law also removed the Medicare coverage gap, known as the "donut hole", for 46 million beneficiaries by slowly lowering drug bills paid by Part-D prescribing plan participants.
Robert Calandra is an award-winning journalist and author who has written extensively on health and medicine. His work has been published in national and regional magazines and newspapers.