Graphic via Desirée Tapia Republicans are still working to repeal the Affordable Care Act
Graphic via Desirée Tapia

If the Affordable Care Act is struck down, tens of millions of Americans would lose coverage and protections for pre-existing conditions. 

As the public health and economic toll of the coronavirus pandemic becomes more grim with each passing day, Republicans are doubling down on their decade-long effort to repeal the Affordable Care Act. Democrats, meanwhile, are working to shore it up by introducing legislation to lower costs, expand coverage, and strengthen protections for those with pre-existing conditions.

The White House this week is expected to file legal briefs officially asking the Supreme Court to end the ACA, even as more than 40 million Americans have filed for unemployment benefits since March. As many as 27 million Americans could lose their employer-sponsored health insurance during the pandemic, according to an estimate from the Kaiser Family Foundation.

The legal briefs, which are expected to be filed on Thursday, come as part of a case brought by a coalition of 18 Republican-led states that are suing to repeal the ACA. The case has the support of President Donald Trump, who said in May that he wants to “terminate” the ACA, even as it becomes a potential lifeline for millions of newly uninsured Americans.

The latest effort isn’t exactly a surprise; Republicans have worked to repeal the law from the moment it was passed, but have been unsuccessful time and time again. Faced with the coronavirus pandemic, they could have opted to end the lawsuit, as the Supreme Court won’t hear the case until the fall. Instead, amid the worst public health and economic crises in a century, the GOP is moving forward with their latest attempt to end the ACA.  

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Passed in 2010 under President Barack Obama, the ACA was the most comprehensive healthcare legislation enacted in decades. Studies have found that it saved tens of thousands of lives and billions in healthcare costs. 

Under the ACA:

  • 36 states and Washington D.C. have expanded Medicaid to cover more low-income Americans;
  • more than 20 million Americans have gained insurance coverage;
  • roughly 135 million Americans have been guaranteed protections for their pre-existing conditions
  • insurers are required to cover essential benefits, such as prescription drugs and chronic disease management; and
  • insurers cannot implement annual or lifetime dollar limits on these benefits, which prevents them from denying care to people with chronic conditions.

If the ACA were struck down, tens of millions of Americans would lose coverage and protections. Repealing the law would also disproportionately harm people of color—the same communities that have been devastated by COVID-19 and whom Republicans already struggle to win over. 

Some within the GOP have acknowledged the dangers of trying to take away healthcare coverage during a pandemic leading into an election. 

“Politically, it’s pretty dumb to be talking about how we need to repeal Obamacare in the middle of a pandemic,” Joel White, a Republican strategist who specializes in health policy, told The New York Times. “We need quick solutions here; we need stuff that we can do tomorrow, because our countrymen are hurting.”

Republicans have yet to propose any “quick solutions,” and their repeal effort was blasted by Peter Morley, a healthcare advocate with a chronic condition who relies on the ACA’s protections to get care.

“The Trump Administration’s continued attempts to destroy the ACA and support of a blatantly partisan lawsuit by a coalition of GOP state attorneys general is outrageous. It is especially cruel to place American lives in uncertainty considering the precariousness of COVID-19,” Morley said in a statement to COURIER. “Instead of this partisan lawsuit, the Trump Administration should be working with Congress on ways to build on the foundation of the Affordable Care Act.”

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While the GOP is focused on gutting the ACA, House Democrats are doing just what Morley advocated for. Speaker Nancy Pelosi on Wednesday introduced legislation to strengthen the law and lower healthcare costs. The bill would: 

  • expand subsidies for healthcare premiums under the ACA, so that families would pay no more than 8.5% of their income for coverage;
  • allow the government to negotiate prices with pharmaceutical companies;
  • allow uninsured pregnant women to receive coverage through Medicaid for a full year after giving birth; and
  • provide incentives to states that have not expanded Medicaid under the ACA to do so.

The bill, which will be voted on Monday, has been praised by Leslie Dach, chair of the healthcare advocacy organization Protect Our Care. He also blasted Republicans’ repeal attempt. 

“The bill introduced by House Democrats [Wednesday] will lower costs, expand coverage, and strengthen protections for pre-existing conditions,” Dach said in a statement. “While Democrats will be moving forward with this bill to improve Americans’ health care, Trump and Republicans are moving forward with a lawsuit that would destroy it — in the middle of a pandemic.”

Pelosi’s bill stands no chance of becoming law since Republicans control the Senate and White House, but it underscores the stark contrast between the two parties on the issue of health care, which is slated to play a key role in the 2020 election, just as it did in 2018, to the benefit of Democrats. Whether it’s Joe Biden at the top of the ticket, or Senate candidates in states like Montana, Iowa, Democrats are once again focusing on a message of protecting and expanding health care, and it seems to be resonating. 

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A Quinnipiac poll released last week found that voters trust Joe Biden on health care over Trump by a 55-41 margin. 

In his statement, Dach summed up just how different the two parties approaches are on the issue of health care: “The choice could not be clearer—one side is trying to rip coverage away from millions of Americans in the midst of a public health crisis while the other is trying to make health care more accessible and affordable for the American people.”