The world of healthcare has been abuzz with news of the Affordable Care Act’s (ACA) future after a recent Supreme Court case concluded. After being challenged by 18 states (and two individuals), the Supreme Court ruled this Thursday, June 17 that the ACA will remain intact.
With the ACA’s fate now secure, let’s take a step back to remind ourselves why the ACA was created in the first place, look deeper into why it was being challenged, and finally, explore what the Supreme Court ruling means for today’s healthcare consumers.
The Affordable Care Act, also known as Obamacare, is a comprehensive healthcare reform law that was signed into law by former President Obama and enacted in March 2010.
The ACA was created with three primary goals in mind:
Since its creation, the ACA has also paved the way for the Health Insurance Marketplaces, also known as the exchanges. The Health Insurance Marketplace is a service that provides individuals, families, and small businesses a “one-stop-shop” to purchase and enroll in affordable medical insurance plans.
This isn’t the first time the ACA has seen requests for repeal. It was first challenged in 2012, and again in 2015, each time being dismissed by the Supreme Court.
This third challenge largely centered on a 2017 decision by Congress to remove the individual mandate from the ACA, which required Americans to be insured with a policy that meets minimum essential coverage (MEC) or face a penalty.
The states fighting for the ACA’s repeal argued that removing the individual mandate penalty made the ACA unconstitutional because the mandate could no longer be justified as a “tax” on citizens. Because of this, and the fact that the mandate is intertwined with other provisions, they felt that the whole law should be done away with alongside the mandate.
In response to this argument, the New York Times cited Justice Stephen G. Breyer as saying:
“The state plaintiffs have failed to show that the challenged minimum essential coverage provision, without any prospect of penalty, will harm them by leading more individuals to enroll in these programs.”
“Neither logic nor intuition suggests that the presence of the minimum essential coverage requirement would lead an individual to enroll in one of those programs that its absence would lead them to ignore. A penalty might have led some inertia-bound individuals to enroll. But without a penalty, what incentive could the provision provide?”
The Supreme Court ruled with a 7-2 vote that the argument lacked standing to challenge the ACA’s constitutionality, and the law’s future remains secure.
With many healthcare consumers benefiting from the ACA and the health plans available through the Health Insurance Marketplaces, the Supreme Court’s ruling is a win for millions of Americans.
Had the ACA been repealed, the Urban Institute estimates that the number of uninsured Americans would have skyrocketed by nearly 70%, with a whopping 21 million Americans losing coverage.
This is largely because of all the low-income adults that are eligible for Medicaid under the ACA, especially after most states expanded the program to include them. The loss of coverage also accounts for the millions of Americans who would have lost their private insurance, including young adults the ACA allows to stay on their parents’ plan until the age of 26.
Many low-income Americans who currently qualify for premium tax credits to help pay for their monthly premiums would also have seen a loss in coverage if the ACA had been repealed.
A Supreme Court ruling against the law would also have taken away the ACA’s protections for Americans with past or current health problems, also known as pre-existing conditions.
Through the ACA, no insurer can deny coverage or change their rates to someone because of their health status. Without the ACA in place, those protections would have disappeared along with the law.
Despite the ACA’s challenges, the Supreme Court has defended it a third time. Through the Supreme Court’s decision, millions of Americans will be able to remain on their private insurance and Medicaid coverage, as well as continue to be protected against health-based discrimination and loss of premium tax credits.