On Tuesday, the United States Supreme Court began hearing arguments in a lawsuit to eliminate the Affordable Care Act, and the healthcare of millions of Americans hangs in the balance. Upholding the ACA will have far-reaching benefits across the country, and the impact on Michigan–including in the northeast part of the state–is particularly high because of our state’s expansion of Medicaid.
This case seeks to invalidate the entire Affordable Care Act because the tax penalty for going without insurance was set to zero through the Tax Cuts and Jobs Act of 2017. But this legal challenge is really only being pursued as a continuation of the partisan fight–and repeated failure–to repeal the ACA legislatively.
And the stakes of this case are too high to be dragging a political fight before the highest court in the land.
A decision to invalidate the ACA would upend our healthcare system, jeopardize consumer protections, eliminate health coverage for millions, and increase insurance and medical costs for millions more.
Invalidating the Affordable Care Act would have far-reaching consequences. Recent estimates from the Urban Institute indicate that more than 840,000 Michiganders would lose their health insurance if the ACA is invalidated. This includes about 70,000 children and more than 200,000 young people between the ages of 19 and 26.
The end of the ACA would also mean the end of Medicaid expansion programs that states established under it. Medicaid expansion has allowed more than 20 million people access to health insurance nationwide, many for the first time. Michigan’s Medicaid expansion program, the Healthy Michigan Plan, has also been highly successful in insuring more residents with lower incomes, especially during the COVID-19 pandemic.
The Healthy Michigan Plan has also helped reduce uncompensated care costs in our state. In 2013, the average hospital in Michigan provided just over $8 million in uncompensated care each year. By 2017, that number was $3.7 million.
Additionally, if the U.S. Supreme Court invalidates the ACA, insurers would once again be able to force certain people to pay more for the same coverage as well as reestablish lifetime limits and annual caps.
The end of the ACA would also mean an end to the essential health benefits which ensure that insurers provide coverage for prescription drugs, substance use disorder treatment, mental health services, and maternity care. And the end of the ACA would mean that preventive services such as cancer screenings and vaccinations would no longer be required to be available at no cost.
And whether it’s asthma, high blood pressure, diabetes or cancer, many people we know and love have preexisting conditions. And protections for those with such conditions would no longer be guaranteed. There’s also concern that contracting COVID-19 could be considered a preexisting condition down the road.
The Affordable Care Act has played a major role in improving the health and well-being of our nation and our state. And in Michigan in particular, the ACA and the related Healthy Michigan Plan have had a tremendous, positive impact on our state and its residents in improved personal health, expanded health coverage, increased healthcare-related jobs, and reduced costs to hospitals and the state.
So many people rely on the ACA’s benefits and protections. And those people, including your own family, friends and neighbors, must not be forgotten as the fate of the ACA shifts to a politically-motivated legal debate. I certainly hope that as the U.S. Supreme Court weighs this issue thoughtfully and carefully, it ultimately rules to protect this vital healthcare law.
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