Under the stewardship of President Barack Obama, Congress passed the Patient Protection and Affordable Healthcare Act (ACA or “Obamacare”) in March 2010. Until then, the United States had lagged behind more than 60 other countries in implementing Universal Healthcare (UHC), including Norway, Japan, Germany, France, Sweden, South Korea, North Korea, Vietnam, Rwanda, and Venezuela, among others.
That’s right. Even some developing countries had UHC before the United States took its first timid steps to protect the health of its people.
Prior to the ACA, insurance companies had free rein over Americans’ health care. They could refuse to cover prescription drugs, hospital stays, maternity care and mammograms. They could flatly refuse to pay for coverage if you were sick. They forced women to pay a higher premium than men for the same care.
What the ACA Does
The whole point of the ACA was to reduce health care costs for those who could not afford them. The plan:
- Provides coverage for individuals with preexisting conditions.
- Allows parents to keep their children on family health care policies up to the age of 26.
- Mandates insurance companies to provide 10 essential services.
Despite the determined efforts of right-wing members of Congress to destroy the Affordable Care Act, and even though they eradicated a key component of the plan (the “individual mandate”), it remains in operation providing essential services to millions of Americans.
The Republican Quest to Overturn Obamacare
Over the last nine years, Republicans have launched no fewer than 70 attacks against the ACA. Sadly for them, Obamacare has worked, and the people have fought for it in the halls of the Capitol.
Seniors, disabled people, and moms and dads pushing their kids in strollers have turned up in droves to plead with their senators and representatives not to take away their access to the health care they need.
Having failed as legislators to repeal Obamacare, Republicans in Congress have turned to the Supreme Court in what we can only hope is their final Hail Mary to make the law go away. And that is why, instead of working to help the country through the worst pandemic in over a century, the Senate rushed to appoint Judge Amy Coney Barrett to the Supreme Court to fill the vacancy left by the late Justice Ruth Bader Ginsburg.
Texas v. California
In 2018, the Texas attorney general led a group of Republican states in filing a lawsuit to ban the ACA. Eventually, the Act found itself before the Texas State Supreme Court, where it was defended by Democratic attorneys general from 17 states and led by California.
The Fifth Circuit Court issued a 55-page ruling that ACA was unconstitutional because of the elimination of the individual mandate, which was a tax penalty for not having health insurance. But there’s nothing odd about penalizing people for not having insurance; for instance, drivers get in serious trouble when we don’t insure our motor vehicles.
The Texas Supremes overturned the lower court verdict and it looked like the ACA might be saved, but the Republicans appealed. SCOTUS agreed to hear the case, and it will be presented today, exactly one week after Election Day.
Ultimate Effect of Losing ACA
Since the pandemic, 12 million people have lost their employer-related health insurance. Individuals under the age of 26, many of whom are suffocating under the weight of student debt, will be dropped from their parents’ insurance policies.
One of the greatest risks of losing the ACA is to the millions of people with preexisting conditions such as diabetes, cancer, asthma, heart disease and now COVID-19. One of the 10 mandated services that insurance companies provide under Obamacare is preventive care, including wellness visits and management of chronic illnesses.
Removing preventive care is penny unwise and pound foolish. Illnesses that can be managed or even prevented today under the ACA will flourish and become the emergency room visits and heart transplants of tomorrow.
Today’s hearing could signal the end of the ACA. Trump’s new Justice Barrett has a record of being in opposition to it. That’s why the Republicans were falling all over themselves to get their judge confirmed, even though it makes screaming hypocrites of them for blocking the confirmation of Merrick Garland, President Obama’s choice to replace Justice Antonin Scalia, nine months before the 2016 presidential election.
It remains to be seen whether Barrett on the bench will be able to set her personal feelings aside. Based on her performance during the confirmation hearings, I believe she can. Let’s hope I’m right.
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