Rounding Up the Risks of the ACA Repeal Lawsuit

The Trump Administration and 18 state attorneys general are supporting a lawsuit that seeks to strike down the Affordable Care Act (ACA). If the lawsuit were to succeed, more than 20 million people would lose health insurance, and millions more would face higher costs for health insurance or health care.

Oral arguments before the Supreme Court are scheduled for November 10. As they approach, we have released new and updated materials outlining the damage that would result from striking down the ACA.

Commentary: ACA Repeal Even More Dangerous During Pandemic and Economic Crisis
Despite the COVID-19 pandemic and resulting major recession, the Trump Administration and 18 state attorneys general, led by Texas, continue to petition the Supreme Court to strike down the entire ACA. . . . The stakes in this case, always extraordinarily high, are even higher now amidst a global pandemic and an economic crisis that has caused more people to lose health insurance and become eligible for help from the ACA. . . .

Suit Challenging ACA Legally Suspect But Threatens Loss of Coverage for Tens of Millions
The ACA remains the law of the land for now, and legal experts across the political spectrum view the case against it as extremely weak. But if the courts “terminate” the ACA, as President Trump again urged in May, some 20 million people would become uninsured — likely many more when accounting for COVID-19’s effects on ACA participation. This brief provides an overview of the lawsuit and its potential consequences.

Commentary: ACA “Alternatives” Don’t Protect People With Pre-Existing Conditions
With the ACA again at risk through the suit to strike down the law that is before the Supreme Court, some of its detractors are backing proposals they say would restore popular protections for people with pre-existing conditions if the law is overturned. But maintaining affordable coverage for people with pre-existing conditions would then require a complete set of rules for insurers and standards for benefits — plus financial assistance to make plans affordable for sick and healthy people alike and avoid the risk of an insurance market “death spiral.” None of the supposed alternatives to the ACA offered by the Trump Administration or congressional Republicans have these features. . . .

Eliminating Federal Protections for People with Health Conditions Would Mean Return to Dysfunctional Pre-ACA Individual Market
The ACA has enabled millions of Americans with medical conditions to obtain affordable, adequate health coverage in all states’ individual insurance markets. It did this not just by barring insurers from denying coverage outright to people because of a health condition, but also by requiring insurers to charge people the same premium, regardless of their health status and to provide a comprehensive array of benefits and cost-sharing protections.

If successful, [overturning the ACA] would mean a return to the highly flawed individual insurance market before the ACA, when people with health conditions often found it impossible to get adequate, affordable health coverage. . . .

ACA Suit Threatens Disruption, Loss of Protections for Tens of Millions of Medicaid, Medicare Beneficiaries
Tens of millions of Medicaid and Medicare beneficiaries face direct harm from a lawsuit to overturn the ACA — which strengthened and updated both programs, transforming Medicaid’s eligibility rules and Medicare’s payment systems. . . .

ACA Repeal Lawsuit Would Cut Taxes for Top 0.1 Percent by an Average of $198,000, Weaken Medicare Trust Fund
At the same time that millions of Americans would lose coverage — and tens of millions would lose key protections and/or pay more for coverage or care — high-income people and certain large corporations would receive very large tax cuts. That’s because striking down the law would eliminate the revenue measures that helped finance the ACA’s coverage expansions. . . .