Oral arguments in the case challenging the constitutionality of the Affordable Care Act (now named California v. Texas) were heard December 10 at the US Supreme Court. If part or all the ACA is overturned, the only way to save the law, and all the protections for Americans that come with it, would be through congressional action.

AzPHA members James Hodge and Jennifer Piatt gave an AzPHA webinar last week discussing the arguments made by both sides and discussing the kinds of questions that were asked by the justices. Sometimes one can get a forecast about where the court is going by listening to the kinds of questions (and statements) made by the justices.

Here is a link to the Webinar Recording and Access Passcode: L12h*ScW. You should watch if you get a chance. The team did a great job preparing.

In a nutshell, our presenters (AzPHA members James G. Hodge, Jr., J.D., L.L.M. and Jennifer L. Piatt, J.D.) were optimistic that the Justices are leaning toward upholding the ACA or at least holding that even though the fees associated with the individual mandate are not bringing in revenue right now that the individual mandate is severable from the rest of the Act (essentially upholding the ACA again).

Let’s hope they’re right.  A decision is expected this summer.

What Happens if the Supreme Court Strikes Down the ACA?

The ACA led to tremendous gains in the rate of children’s health coverage in Arizona. As CAA’s most recent KIDS COUNT Data Book demonstrates, the rate of uninsured children in our state dropped from 13% in 2012 to 8% in 2018. While funding for outreach and enrollment support has been cut, anti-immigrant rhetoric and policies, such as the new public charge rule, has deterred many families from enrolling in health care.

The Urban Institute recently projected that more than 21M Americans will be newly uninsured in 2022, including 1.7 million children if the ACA is overturned by the Supreme Court. Those most at risk of losing coverage are people with incomes below 200% of the federal poverty level and people of color. In Arizona alone 223,000 non-elderly individuals are likely to become uninsured if the ACA is repealed. 

Other key protections that would be lost include:

  • A guarantee that plans cover the 10 essential health benefits;

  • Marketplace insurance plans and the subsidies that make them more affordable;

  • Protections for pre-existing conditions and a guarantee that folks with pre-existing conditions can’t be charged more;

  • Medicaid expansion;

  • The ability to keep dependents on health insurance plans until they’re 26The chance to keep dependents with disabilities on your insurance indefinitely, and

  • A host of other wellness incentives (and a whole lot more).

Until we have a ruling from the Supreme Court (which likely won’t happen before next spring) the ACA remains the law of the land. The annual open enrollment period began November 1, and will continue through December 15. The ACA Marketplace, Medicaid expansion, and KidsCare continue to cover tens of thousands of Arizona children and families.