WASHINGTON (AP) – The 10-year-old health care law that divided Americans as it expanded coverage and protected people with pre-existing illnesses is being put to the test. In the midst of a pandemic, President Donald Trump and some Red States want the Supreme Court to declare the affordable care law unconstitutional. The Blue States and the US House say the case has no merit.
Here are questions and answers as the case unfolds:
WHAT IS HAPPENING NOW?
In the real world, very little will change immediately. Politically, it is another story.
It is not known whether the court will hear oral arguments before the November elections. A decision is not likely until next year, which means that the ACA will remain in place for the foreseeable future.
Even if a majority of the Supreme Court descends on the side of opponents to “Obamacare”, the unraveling of the 10-year law would be long and fraught with political risks. Many ACA provisions are popular, such as guaranteed coverage for people with pre-existing medical conditions and free contraceptive coverage for women. Others are connected to the health care system, such as the changes to Medicare payments and the strengthening of legal authority against fraud.
Politically, Trump’s relentless opposition to the ACA is spurring Democrats ahead of the November elections.
As if it were the right time, House Speaker Nancy Pelosi introduced a bill to expand the health care law and the House is expected to vote on Monday.
The objective is not so much to pass a law, because the Pelosi bill will not be examined by the Senate under Republican control. But that can cause some Republicans to squirm by forcing them to vote that their Democratic opponents can use in campaign announcements this fall.
“God willing, the courts will do the right thing, but we just don’t know,” says Pelosi. “So we are preparing for the future.”
HOW DOES OBAMACARE WORK?
Remarkably well, despite the dramatic declarations of politicians on both sides.
Larry Levitt of the non-partisan Kaiser Family Foundation estimates that approximately 23 million people are covered by the law, about as much as when former President Barack Obama left office.
This includes approximately 12.5 million people covered by Medicaid extensions in most states and some 10 million through health insurance markets like HealthCare.gov which offer individual plans subsidized by taxpayers.
According to Gallup, Americans under Trump have tipped in favor of the ACA or have been narrowly divided. However, during Obama’s last term, the public more often opposed the law. Fifty-two percent approved ACA in March, while 47% disapproved.
A turning point came when Trump and a GOP congress failed to repeal Obamacare in 2017.
DOES ACA MAKE A DIFFERENCE IN THE COVID-19 PANDEMIC?
He took on a new role. ACA coverage can be a lifeline for people who have lost their health insurance as a result of layoffs.
The Kaiser Family Foundation recently estimated that nearly 27 million people had lost their employer coverage due to layoffs related to a pandemic, and almost 80% would be eligible for Medicaid or an Obamacare plan with subsidized premiums.
New government figures show that registration for HealthCare.gov increased by about half a million people in the middle of the pandemic.
WHAT WOULD BE THE PROTECTION OF PEOPLE WITH PRE-EXISTING CONDITIONS?
It is a source of anxiety for many Americans.
A Kaiser Foundation survey in January found that 57% were concerned that they or a family member would lose their health insurance if the Supreme Court canceled ACA protections for people with preexisting illnesses. Under Obamacare, insurers cannot use a person’s medical history to refuse or make them pay more.
The Trump administration argued in court that constitutional flaws in the law would also entangle its protection for people with pre-existing conditions.
Yet Trump has promised that he will preserve these guarantees, without developing a plan to do so.
Some prominent Republicans say they never intended to undermine protections for people with pre-existing conditions when they voted to repeal Obamacare’s unpopular fines for uninsured people. This repeal is the source of the ongoing legal proceedings, as opponents of the law contend that without the fines, the entire statute is made unconstitutional.
Traditionally, Republicans have supported protections for people with pre-existing conditions, but with a limitation that individuals must maintain their coverage to qualify.
O’S IS JOE BIDEN IN ALL THIS?
He supports the signing legislation of his former boss.
The Democratic presidential candidate says that if elected president, he will rely on ACA to bring the nation closer to coverage for all. Biden would increase health law subsidies for individual private plans, complete the expansion of Medicaid, and create a new “public option” alternative on the Medicare model.
WHAT ARE THE UNITED STATES DOING ABOUT ACCESS TO HEALTH INSURANCE?
Under Trump, the uninsured rate had started to rise again. The economic shutdown in an attempt to slow the spread of the coronavirus has likely made the situation worse, but government figures are not available to quantify the impact.
The Census Bureau reported last year that 27.5 million people, or 8.5% of the population, had no health insurance coverage in 2018. This represents an increase of 1.9 million people. uninsured, i.e. 0.5 percentage point, compared to 2017.
It is not known how many people who lost their employer coverage during the pandemic ended up uninsured.
Source: AP News