As the countdown to election day draws near, the Affordable Cares Act (ACA) stands on shaky ground – a position that concerns the millions of Americans with pre-existing health conditions.
The recent death of Supreme Court Justice Ruth Bader Ginsburg has not only made an already tumultuous general election campaign more chaotic but put the ACA in its most precarious position yet.
The ACA, or Obamacare as many have come to know it, protects people with pre-existing health conditions. It ensures that health insurance companies can’t refuse to provide coverage to those with pre-existing health conditions, charge them more, engage in gender rating, or refuse to pay for “essential health benefits” including pregnancy.
It isn’t just the elderly that the ACA protects. According to the Centers for Medicare and Medicaid Services, between 50 and 129 million non-elderly Americans have at least one pre-existing condition that would threaten their access to health care and health insurance. According to a 2019 study from Kaiser Family Foundation, more than 1/3 of the American population aren’t eligible for Medicare and have health conditions that could make them uninsurable without protection for pre-existing conditions.
As if those numbers aren’t staggering enough, the Kaiser Family Foundation claims COVID-19 is considered a pre-existing condition. This means that as of October 26, 2020, the 8,553,827 Americans who have tested positive for COVID will now have a pre-existing condition.
What is particularly alarming about the current legal status of the ACA is the fact that just one week after the election, the Supreme Court is slated to address the case now known as California v. Texas. While it is uncertain which way the justices will vote, many are concerned the most recent addition of Justice Amy Coney Barrett to the court could potentially secure a 5-4 ruling against the law.
President Donald Trump continues to promise to “protect patients with pre-existing conditions,” but his administration has yet to propose a specific plan to Congress on how patients with pre-existing conditions would remain protected should the ACA fall. While he did sign an executive order related to these conditions in September, Douglas Holtz-Eakin, president of the American Action Forum, claims it was just “to say very firmly that the health secretary is going to have to figure this out.”
Should the ACA Fall without a Clear Replacement:
At least 20 million Americans could lose health coverage right away
Many more would lose protections against their pre-existing health conditions
Adult children under age 26 would no longer be guaranteed the right to remain on their parents’ health plans
Medicare patients would lose enhanced prescription drug coverage
Women would lose guaranteed access to birth control at no out-of-pocket cost
As it stands, the fate of the ACA and pre-existing conditions protection remains uncertain. What is clear, however, is that many do and will continue to rely on protections like what the ACA offers for pre-existing conditions. The outcome of the coming months will not only determine the future of the ACA, but the future of pre-existing condition coverage.
