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Tomorrow, the Supreme Court will start to review the latest suit against the Affordable Care Act.
If the high court, with a newly strengthened conservative majority, were to overturn the law following this week’s oral arguments, health insurance would collapse for at least 23 million Americans. Nearly 11 million would lose coverage through marketplaces created under the ACA to sell private health plans, usually with federal subsidies, to people who cannot get affordable benefits through a job. And about 12 million, insured because of Medicaid expansions in all but a dozen states, could find that coverage disappear.
“Overturning the ACA would affect almost everyone, one way or another,” said Larry Levitt, senior vice president of the Kaiser Family Foundation, a nonpartisan health policy group. It would “put the health system into chaos and the political system into chaos, as well,” he said.
Covid-19, the illness caused by the coronavirus, could be classified as a preexisting condition, throwing into doubt coverage of ongoing treatment for some patients who suffer lingering effects and sometimes need care long after they contract the virus.
The court’s likelihood of striking down the law this time, ending insurance protections for people with covid-19 or other medical conditions, is a matter of debate. Since early 2018, when a group of Republican attorneys general launched the lawsuit that has evolved into the Supreme Court case, health law scholars who support and oppose the ACA have uniformly contended that the suit’s legal arguments are weak.
If the court struck down the full law, Congress would face intense pressure to restore at least parts of it — especially now, said James C. Capretta, a resident fellow at the American Enterprise Institute who focuses on health care.
My opinion is that the Supreme Court would be foolish to do anything beyond ruling against the lawsuit. Since this is 2020, though, anything is possible.