UPDATE: State Leaders’ Fight to Take Health Care Away from Texans Goes to the Supreme Court

On November 10, the U.S. Supreme Court will hear oral arguments for the harmful Health Care Repeal Lawsuit, which would eliminate the entire Affordable Care Act (ACA) with no replacement. The Supreme Court will issue its decision in 2021, possibly as late as June 2021. Despite this dangerous case, Marketplace open enrollment for 2021 coverage is happening NOW and will end on December 15, 2020. People who need affordable coverage for 2021 should sign up now; financial assistance and free enrollment help are available.

Texas Attorney General Ken Paxton is leading the group of states suing to take health coverage and economic security away from millions of people across the country, and he’s doing that in the middle of a worsening pandemic:

  • As the nation experiences prolonged COVID-19-related job-losses, ACA coverage remains available and affordable to many people losing their job-based health insurance. 1.6 million Texans lost job-based health insurance between March and early May. Nearly 900,000 of them would have been able to purchase reduced-price insurance on HealthCare.gov, if they acted within 60 days of losing their other coverage. Texas has steadfastly failed to adopt the ACA’s Medicaid expansion. But, if we followed the 38 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 structural racism lies at the root of the vast inequities that place a far larger burden from COVID-19 on people of color, 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 if the ACA is overturned. 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 once again to 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 currently 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 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 and visit their website.

This is an updated version of a blog post made by Every Texan Senior Policy Analyst Stacey Pogue on June 23, 2020.

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