The John Minor Wisdom U.S. Courthouse, home of the Fifth Circuit, New Orleans. Photo Credit: Wikimedia
On July 9th, at around 1 p.m. in New Orleans, lawyers representing 17 Republican-led states will file into one of the courtrooms of the Fifth Circuit Court of Appeals for the case of Texas v. United States. There, backed by the White House and the Department of Justice (DOJ), they will argue for the complete dismantling of the Affordable Care Act (ACA). In a move opposed by a majority of people in this country, the Texas-led coalition will insist upon the end of protections for pre-existing conditions –– opening the door for 130 million people to be denied coverage or be forced to pay higher premiums.
A quick recap of the case: In February 2018, these Republican attorneys general filed a lawsuit arguing that the end of the individual mandate provision invalidates the entire ACA. In December 2018, Judge Reed O’Connor agreed with them in a district court ruling that was widely criticized as being politically motivated and unsound from commentators across the ideological spectrum. Now, as the appeals court looks to rule, the Trump administration’s DOJ has not only declined to defend the law, but has agreed with the Republican plaintiffs that the ACA should be totally demolished.
So what does this mean?
Forget, for a second, all the legalese and the briefs and the courts. At its core, this lawsuit shines a light onto role of these attorneys general and the Trump administration in supporting a devastating outcome that would impact the lives of millions, including nearly every person in the country. Protections for the 130 million people with pre-existing conditions? Gone. Increasing the rate of uninsured by 65 percent. Coverage for the 17 million insured under Medicaid expansion? Gone. Protections allowing 2.3 million adult children to stay on their parents’ insurance? Gone. And as for protections that keep insurance companies from charging women and older people more? Bans on lifetime caps and six-figure premium surcharges? You guessed it, nope, zip, nada.
Even amidst the maelstrom of attacks that the administration is waging on health care from all sides –– including allowing discrimination against trans people, undermining access to reproductive care, and targeting immigrant families –– this case stands out for the sweeping effect it would have on millions of people across the country.
The Texas case also demonstrates the lengths Republican leaders are willing to go against the wishes of millions of people across the nation. As polls have shown, 70 percent of Americans support protections for pre-existing conditions and a majority, including over half of Republicans, do not want to see the courts overturn the ACA.
What can we do?
So yes, this case poses a serious threat. But while it’s easy to feel helpless about judicial developments taking place in a courtroom, there are concrete actions you can take: You can call or write your attorney general thanking them for defending the ACA or demanding they withdraw from the plaintiffs’ side. You can encourage your state elected officials to enact as many protections as possible, if they haven’t done so already. You can ask your state government to analyze what effects an ACA repeal would have on your state’s health care and economy.
And beyond these concrete actions, Texas v. United States has actually given us a powerful tool to highlight the work currently underway to increase quality of care and access to coverage. Despite this pending lawsuit that aims to take away the health care of millions, Democratic officials and House Democrats stepped in to defend the case and passed bills in the House to protect pre-existing conditions and strengthen the ACA.
The long game
These action steps and contrasting narrative matter because the battle for the ACA will not be won or lost in this summer in a New Orleans courtroom, but in the days and weeks and months ahead. The strategy is much longer than that; health care is primed to be one of the most important issues of 2020.
We cannot let people forget what the Texas case is and what it represents: a sharp rebuke of the wishes of the public and an attempt to destroy protections for millions, including those with pre-existing conditions, in a single blow. This lawsuit lays out a dystopian health care future and takes us in exactly the wrong direction, away from current, praiseworthy initiatives to protect people with pre-existing conditions and increase quality and access. The Texas lawsuit should be enraging and galvanizing, a clear symbol of what we risk losing and what we need to protect as we head into 2020.
So when oral arguments begin on July 9, it should serve as a reminder that this case cannot go unnoticed and unprotested by the public and our elected officials. The game is long, and millions are counting on us to stand up for their health care––not just on July 9, but into 2020 and beyond.