When Senate Democrats aren’t making thinly veiled criticisms of Judge Amy Coney Barrett‘s deeply held religious beliefs, their strategy to make Americans scared of the Supreme Court nominee is to focus on health care. Specifically, they argue Judge Barrett would be a deciding vote to declare the fatally flawed Affordable Care Act (ACA) unconstitutional—which, they say, would eliminate health care coverage for millions of Americans.
That claim, of course, is the boogeyman the Left has been using for more than a decade to prevent reforming our broken health care system. Ending the ACA could provide the impetus that Congress and all 50 states need to address our system’s major problems and put patients in charge of their own care.
The truth is the vast majority of Americans would be unaffected by invalidating the law because they are not part of the Medicaid expansion group or enrolled in an individual plan on the ACA exchanges. If you have private coverage, nothing the Supreme Court could decide in Texas v. Azar would take that away. Same goes for those on Medicare.
As for the roughly 25 million people in the expansion group or on the ACA exchanges, the reality is that while they technically have “coverage,” many can’t get care because they don’t have a doctor, have limited network options or end up paying out of pocket anyway. The ACA ran providers out of Medicaid in droves, and the high deductibles force people to forgo care or spend thousands of their own dollars before insurance kicks in.
To underscore the point, even after a decade of the ACA, 15 million people today who are eligible for free or low-cost health insurance don’t take it.
And what about protecting people with “pre-existing conditions?” They might have a lower premium, but, again, what good is paying for insurance if you’re paying tens of thousands of dollars out of pocket until you meet your high deductible? Not to mention, there is no evidence that the ACA improved mortality or reduced health care-related bankruptcies—the two main reasons for including these protections.
The most immediate effect of invalidating the ACA would be to allow states the freedom to combat the law’s most disastrous effects.
The ACA is a shrine of broken promises. Contrary to the way it was sold a decade ago, premiums have skyrocketed, costs have exploded, choices have been severely limited, patients have less access to care providers and people are still going bankrupt. But because of unconstitutional regulations and mandates in the law, states are handcuffed from making changes that would increase options, lower costs and improve health outcomes.
The president can only do so much. For his part, President Trump has announced several executive orders to put patients first. He has acted to improve price transparency, create personalized health care options in the market and expand how patients can use their own dollars for care.
And he’s recently introduced the America First Health Plan, which would go much farther to reduce prescription drug costs, invest in telemedicine and open up options like direct primary care. The plan protects Medicare for seniors, lowers premiums and ends the indefensible practice of surprise billing.
But still, the ACA stands in the way of patients and their care. Far from eliminating insurance, invalidating the law will allow patients to get the kind of insurance that meets their needs at a price they can afford. It will open up a flurry of new and cheaper choices for the vast majority of Americans in the private market. It means states can fix Medicaid for those it was intended to help, instead of pushing more people into a broken system. And it frees states to protect the most vulnerable with guaranteed coverage pools, like the one in Texas that stands ready to be deployed if the ACA is invalidated.
The right decision on the ACA will help Americans fix what’s broken in our health care system and lead to enacting real reforms that put patients in charge of their own health.