The Affordable Care Act (ACA) was already in peril after a federal judge in Texas invalidated the entire law late last year. But the stakes ramped up again last week, when President Trump’s Justice Department announced it had changed its position and agreed with the judge that the entire law, not just three pieces of it, should be invalidated.
The administration had previously said that the law’s protections for people with pre-existing conditions should be struck down, but that the rest of the law, including the expansion of Medicaid, should survive.
A coalition of states is appealing the ruling, which could have dire consequences for millions of people. That includes 9.2 million who receive federal subsidies.
If it is upheld, tens of millions more people would be affected than those who already rely on the nine-year-old law for health insurance. Also known as Obamacare, the law touches the lives of most Americans, from nursing mothers to people eating at chain restaurants.
Medicaid, the government insurance program for the poor that is jointly funded by the federal government and the states, has been the workhorse of Obamacare. If the health law were struck down, more than 12 million low-income adults who have gained Medicaid coverage through the law’s expansion of the program could lose it.
In all, according to the Urban Institute, enrolment in the program would drop by more than 15 million, including roughly three million children who got Medicaid or the Children’s Health Insurance Program when their parents signed up for coverage.
We do know Trump has no empathy at all with unhealthy people nor with their surroundings, but losing free health insurance would, of course, also mean worse access to care and, quite possibly, worse health for the millions who would be affected, whilst those who can swim in their money would not have to worry, being able to have their private insurance company taking care of them.