On September 5, Fort Worth will take center stage in the national fight over health care coverage and protections for people with pre-existing conditions.
Last year, Congress tried many times, unsuccessfully, to repeal the Affordable Care Act (ACA). Now, the Texas Attorney General is leading an effort with 19 other states to overturn the ACA in court. Their lawsuit argues that when Congress got rid of the individual mandate penalty as part of the Republican tax bill in 2017, that rendered the entirety of the ACA unconstitutional.
Oral arguments in the lawsuit take place Wednesday in a federal court in Fort Worth. This lawsuit could strip insurance coverage from 20 million Americans and send us back to the bad old days, before we had health care protections for people with cancer, asthma, and other pre-existing medical conditions.
The Texas Attorney General has asked the judge to invalidate the ACA nationwide, but if the judge won’t, the AG has proposed a “fallback position” — end pre-existing condition protections in the 20 states that filed suit right away, before the end of 2018. Either of these requests would create substantial harm. The Trump administration has also asked the court to end pre-existing condition protections. Attorneys general from 17 states led by California have intervened in the case to defend the ACA.
Ending pre-existing condition protections
ACA “pre-existing condition protections” mean you can’t be denied coverage or charged more due to something in your medical history. Americans overwhelmingly support ACA pre-existing condition protections. A recent Kaiser Family Foundation poll found that 90 percent of Americans think it is important to maintain current protections, and support cut across party lines.
Roughly half of all non-elderly Americans (age 0-64) have a pre-existing condition — like high blood pressure, high cholesterol, mental health disorders, asthma and many other types of conditions – that would have caused them to be denied insurance or charged more if they needed to buy insurance on their own, outside of a job. In other words, pre-existing conditions are common and maintaining protections for them is vital for people who need to access health care.
Invalidating the entire ACA
Invalidating the ACA would have devastating consequences. In addition to losing pre-existing condition protections discussed above, 20 million low- and moderate-income Americans would lose coverage they gained under the ACA. In Texas, the 908,000 people who receive subsidies to help them afford Marketplace coverage would lose them, and our uninsured population would climb. Since the ACA passed, Texas’ uninsured population has dropped by more than 1.2 million people.
People with job-based insurance would be harmed too. The 180 million Americans who get health insurance through their employer or purchase it on their own would lose basic consumer protections that were included in the ACA—such as the provision that allows young adults up to age 26 to be covered under a parents’ plan, the prohibition on lifetime caps on coverage, and free preventive care.
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