What’s at Stake: SCOTUS, the Affordable Care Act, and Health Care for Millions of Americans

As our nation mourns the passing of Justice Ruth Bader Ginsburg, the Trump administration and Senate Republicans are now rushing to confirm a conservative Supreme Court pick, Amy Coney Barrett, who shares their aim of ending the Affordable Care Act (ACA) and the health and economic security it provides to millions of people across the country.  

If they are successful, Judge Coney Barrett could be seated in time to participate in oral arguments in the Health Care Repeal Lawsuit. 

What’s the Health Care Repeal Lawsuit? 

In case you missed it: In the midst of an increasingly severe public health crisis and the biggest economic downturn since the Great Depression, the Trump administration, 17 Republican attorneys general and one Republican governor are pursuing this lawsuit, also known as California v. Texas, with the goal to topple the entire health care system. If successful, it will end the ACA and all of the consumer protections it provides, leaving millions of Americans without preventive care, treatment options or long-term coverage. On November 10th, the Supreme Court will hear oral arguments on the case.  

In September, following Justice Ginsburg’s passing, the House Committee on Energy and Commerce held a hearing, Health Care Lifeline: The Affordable Care Act and The COVID-19 Pandemic, which Community Catalyst submitted a statement to reinforcing the important role the Affordable Care Act (ACA) plays in our health care system.  

Below is a summary of our comments,  and how we can continue fighting back as health justice advocates to protect the ACA.  

The ACA has provided a safety net for millions of people before and during the COVID-19 pandemic. 

Thanks to the ACA, roughly 20 million people have gained coverage. The uninsured rate fell by almost half, from 20.4 percent to 12.4 percent, between 2013 and 2018, as the result of ACA marketplaces and Medicaid expansion. The law has led to historic reductions in racial disparities in access to health care. Between 2013 and 2018, the uninsured rate dropped 4.1 percentage points between Black people and whites and 9.4 percentage points between Latinos and whites. These coverage gains have made it easier for people to access the health care services they need. Though more must be done to improve affordability, most low-income individuals and families have benefited from the law’s insurance subsidies, out-of-pocket cost protections and Medicaid expansion.  

The COVID-19 pandemic has caused broad shutdowns of economic activity, resulting in nearly 30 million people losing their jobs and employer-sponsored health insurance coverage. Workers of color are most vulnerable for potential layoffs during a downturn, as they are overrepresented in low-wage, service industry jobs. Nearly 1 in 10 Blacks and 1 in 10 Latinos are projected to lose coverage, compared to 1 in 6 whites. The ACA is and will continue to be a lifeline for those who lose their employer-sponsored health insurance. According to the Kaiser Family Foundation, half of those who become uninsured after job loss are eligible for Medicaid, and an additional 8.4 million people are eligible for marketplace subsidies.  

Without the ACA, our fight against the COVID-19 pandemic will be harder.  

While the COVID-19 crisis has brought to light many faults in national, state and local infrastructures, the ever-present truth threaded throughout the unfolding narrative is that pervasive health and economic inequities are resulting in dramatically disproportionate impacts.  The virus does not discriminate, but Black and brown people are being hit especially hard as they are more likely to be exposed to the virus through their work in occupations that are considered essential and/or in which they cannot physically distance themselves from others or work from home. In addition, due to power structures built on structural racism that continue to segregate neighborhoods and inhibit equitable access to preventive health care, many people of color are forced to live in places that negatively affect their health. As a result, compared to whites, people of color have higher rates of underlying health conditions and face a greater risk of becoming severely ill if infected by COVID-19.  

One of the cornerstones of the ACA is the protections it provides for people with pre-existing health conditions. Thanks to the ACA, at least 135 million people with pre-existing conditions have been protected from being charged more or locked out of coverage by private insurers. COVID-19 has created a number of cascading health care and health care coverage crises that need to be accounted for in our efforts to keep the ACA intact. The virus itself will be defined by insurers as a new pre-existing condition for those who have “recovered.” 

So, what can we do to fight back? 

As health justice advocates, we must continue to educate and activate our communities in opposition to the Health Care Repeal Lawsuit. Here are a few ways you can plug in to the work: 

Together, we can – and must – protect the Affordable Care Act, defend health coverage for millions, and keep fighting for health justice in our country.