State Leaders Resume Fight to Take Health Care Away from Texans, This Time at the Supreme Court

The U.S. Supreme Court has agreed to hear the harmful Health Care Repeal Lawsuit—which would eliminate the entire Affordable Care Act (ACA) with no replacement—in its next term that starts in October 2020. Oral arguments in the case will be held this fall with a decision issued in 2021, but legal filings at the high court have already started and will continue through the summer.  

On Thursday, June 25, a group of states led by Texas Attorney General Ken Paxton and the Trump administration will file their opening briefs with the Supreme Court. We’ll likely see the same dangerous arguments they’ve made for years in their efforts to take health coverage and economic security away from millions of people across the country.

While their arguments probably won’t change, the country has changed profoundly. The ACA has proven itself even more essential over the last few tumultuous months:

• As the nation experiences staggering COVID-19-related job-losses, ACA coverage remains available and affordable to many people losing their job-based health insurance. 1.6 million Texans already lost job-based health insurance in just March and April. Nearly 900,000 of them can purchase reduced-price insurance on HealthCare.gov, if they act within 60 days of losing their other coverage. Texas has steadfastly failed to adopt the ACA’s Medicaid expansion. But if we followed the 36 states that have already adopted Medicaid expansion, we’d be far better equipped to ensure that people losing jobs during this recession can maintain health coverage.
• As we recognize that systemic racism both lies at the root of the health disparities that make COVID-19 more lethal for Black Americans and allows policy brutality to persist, we know that the ACA led to historic reductions in racial and ethnic disparities to both health coverage and health care access nationwide.

It would seem unthinkable in the current environment to throw out the system that is both the primary safety net for coverage during a period of staggering job losses and a tool to reduce racial and ethnic disparities in access to coverage and care. Especially when Texas’ leaders have no plan whatsoever to ensure access to health care and coverage for Americans. Yet, the Texas Attorney General and others will argue to do just that this week.

Poll after poll shows Texans want lawmakers to focus on improving access to health care — not taking it away. If the Attorney General’s misguided lawsuit ultimately results in eliminating the ACA, it would have devastating effects on Texans and people across the country: 20 million Americans would lose their health care coverage, insurance companies would be allowed to once again discriminate against people with pre-existing conditions, and seniors in Medicare would pay more for prescriptions.

Examples of harm to Texans

• 1.7 million Texans would lose their health care coverage. The state’s uninsured rate would shoot up by 37 percent.
• People with a pre-existing condition — like high blood pressure, high cholesterol, diabetes, and asthma — would lose protections. Under the Affordable Care Act, they are assured that they will not be denied coverage, charged more, or face waiting periods due to something in their medical history. More than 1-in-4 Texas adults ages 18-64 would have been denied individual market coverage before the ACA because of a pre-existing condition, and many more would have faced higher premiums or reduced coverage.
• Texans would lose the guarantee that their health plan will cover preventive services – like flu shots, mammograms and other cancer screenings, and contraception – at no cost to patients. This would harm 10.3 million Texans, most of whom have job-based insurance.
• 205,000 young adults in Texas who gained coverage by being able to stay on a parent’s plan to age 26 would lose access.
• Texans would lose a $5 billion/year investment of federal Marketplace subsidies that connect 950,000 low- and moderate-income Texans to coverage.
• Seniors in Texas would have to pay more for prescription drugs because the Medicare “donut hole” would be reopened. In Texas, 333,500 seniors saved money on drugs in 2016, and from 2010-2016, Texans in Medicare saved $1.8 billion.
• Insurance companies would once again be able to place lifetime caps on your coverage and charge women more than men.
• Required coverage of “Essential Health Benefits” – like mental health treatment, prescription drugs, and maternity – would end.
• Texas would lose the option to accept federal Medicaid expansion funding to cover uninsured, low-wage Texans in the future. This option – so far been rejected by Texas leaders – could cover 1.5 million uninsured Texas adults.

What Texans and Americans want with respect to health coverage

Attorney General Paxton’s lawsuit that would take health coverage away from Texans and end pre-existing condition protections stands in stark contrast with what Texans and Americans want.

Recent Texas polling from the Episcopal Health Foundation shows:

• 88 percent of Texans say they think health insurance companies should be required to provide coverage for people who have pre-existing health conditions.
• 85 percent think increasing access to health insurance should be a “top priority” or “important” for the Texas Legislature (57percent say top priority and another 28 percent say important, but not a top priority).
• 64 percent of Texans support Medicaid expansion.

In addition, polling from the Kaiser Family Foundation (summary of findings from many polls here) shows that strong majorities across political parties support key Affordable Care Act provisions such as pre-existing condition protections; marketplace subsidies that make coverage more affordable; allowing young adults to stay on a parent’s plan to age 26; preventive health care with no out-of-pocket costs; and coverage of Essential Health Benefits.

Texans have benefited from the ACA for a decade. It is now more popular than ever, and at the same time, it hangs in the balance because of the Health Care Repeal lawsuit.

Texans want our leaders to improve access to health care, not take it away. Follow Every Texan on Twitter for updates on this litigation. For ways to get active in support of health care access and coverage follow #SickofItTX on Twitter at visit sickofittx.org/

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