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12 Years Later The ACA Stands Strong Despite An Endless Series Of Republican Attacks on Health Care

By March 21, 2022No Comments

After 12 Years, Republicans’ Continue Efforts to Repeal and Sabotage ACA, Oppose Medicaid Expansion, and Put Insurance Company Profits Over What’s Best for American Families

Twelve years after the Affordable Care Act was signed into law, the historic health care legislation is stronger and more popular than ever. More than 30 million Americans are covered by Medicaid expansion and ACA Marketplace plans, which have improved health outcomes and financial stability, while reducing medical debt and racial disparities in care. This should be cause for everyone to celebrate, however Republicans continue to oppose, sabotage and threaten the ACA. Despite suffering stinging defeats over health care in 2018 and 2020, Republicans seem open to running on the same repeal and sabotage agenda in 2022, in an attempt to strip health care from millions of Americans. 

Republicans Are Still Fighting The Affordable Care Act In Congress

For more than a decade, Congressional Republicans led the charge to kill the ACA. Whether it was pushing vote after vote, pursuing lengthening filibusters, or shutting down the government, Republicans never missed an opportunity to sabotage the ACA. 

Republicans Have Voted To Destroy Or Dismantle The ACA 100 Times. Despite the overwhelming popularity of the ACA, Republicans attempted a seemingly never ending series of fruitless votes to repeal, modify, or gut the historical health care law. 

Republicans Attempted To Rip Protections From Vulnerable Patients. More than 135 million Americans have a pre-existing health condition. Before the Affordable Care Act, insurance companies routinely denied people coverage because of a pre-existing condition or canceled coverage when a person got sick. While some Republicans remained determined to repeal the ACA, without a single alternative, others attempted to provide themselves with political cover in the form of plans that would stick sick Americans with cost prohibitive ‘coverage’. The Graham-Cassidy-Heller-Johnson bill did just that. This bill would have allowed states to waive key parts of the ACA such as the “essential health benefit” provision. The health research firm Avalere, found that under Graham-Cassidy, “you can be charged more for a specific condition.”

Republicans Still Have Not Abandoned Efforts To Repeal The ACA. In an interview with Breitbart News Radio, Senator Ron Johnson said the Affordable Care Act should be repealed if Republicans take back power in 2024. This comes despite the fact the Affordable Care Act is more popular than ever and experienced record enrollment in 2021, with 14.5 million Americans enrolling in a Marketplace plan. Johnson’s statements showed the undeniable tension in the Republican party that seems unable to move on, even after countless defeats in the halls of Congress, state houses across the country, and at the Supreme Court. 

Trump And His Cronies Waged War OnThe Affordable Care Act In The White House

When President Trump took office, he promised to repeal and replace the ACA with his party’s control of Congress. Even with majorities in the House and Senate, Republicans still managed to walk away empty handed and with 41 fewer House seats, losing their brief and turbulent majority, largely due to their attacks on the ACA. 

Republicans Peddled Junk Plans In An Attempt To Destabilize The Market. In 2018, the Trump Administration finalized a rule expanding the availability of “short-term, limited duration” plans that are not required to cover pre-existing conditions. Short-term plans offered bare-boned, skimpy coverage and were originally designed to be temporary coverage and limited to three months in duration, but the former administration allowed them to be available for 364 days and renewed up to three years. Junk plans can also deny coverage for prescription drugs, preventative care, and other essential health benefits. Experts warned that, in addition to hurting the people who purchase this substandard coverage, reviving junk plans could increase premiums and destabilize the market for everyone else.

The Trump Administration Perpetrated An Endless Series of Attacks. The last administration used every opportunity to lash out at the ACA. Despite federal courts blocking Medicaid work requirements, Trump granted waivers in 12 states for eligibility or work requirements for Medicaid recipients. Trump’s Department of Health and Human Services issued a rule to weaken a ban on discrimination against LGBTQ Americans, women, and people with disabilities in health care and insurance coverage during Pride Month in 2020. In 2019, the Trump administration announced a rule allowing employers to encourage their employees to buy junk plans that do not cover people with pre-existing conditions, which targeted older, sicker workers for higher premiums. Just days before leaving office, Trump approved a Tennessee proposal to transform the state’s Medicaid program into a block grant. Block granting Medicaid funds has been repeatedly rejected by Congress and is seen by health care experts as blatant attempts to gut coverage and kick people off the rolls.

Republican Governors Fighting The Affordable Care Act In The States

In 2014, states were given the opportunity to expand their Medicaid programs and millions have since gained access to quality, life saving coverage. Despite the overwhelming popularity of Medicaid, and its ability to increase financial stability and improve health outcomes, a small group of Republican controlled states have held their residents hostage for political points. This is a losing game. When voters are given the choice, they choose Medicaid expansion. 

Republicans Blocking Medicaid Expansion At Every Turn. There are currently more than four million Americans that could enroll in Medicaid coverage if the remaining states implemented expansion, but are blocked from coverage solely because they live in a non-expansion state. Republican leaders in the 12 states that have refused Medicaid expansion have spent years undermining the ACA. By rejecting expansion, these states are putting rural communities, people of color, and other vulnerable groups at high risk for purely political reasons. While they continue to pander to the most extreme parts of their bases, Medicaid expansion has become increasingly popular among voters. 75 percent of Americans have a favorable view toward the Medicaid program, and 61 percent of Americans in non-expansion states favor expansion. 

When Voters Approve Medicaid Expansion, Republicans Don’t Respect The Will Of The People. In August 2020, voters in Missouri approved expansion, but Republicans in the state legislature refused to fund the program, leading to a months-long legal battle. While Republicans dragged their feet, 275,000 Missourians went without Medicaid coverage. Previously, Missouri did not permit coverage for most adults without children, and set its income eligibility threshold at one-fifth of the federal poverty level, or $5,400 for families of three in 2021. GOP legislators cited budgetary restrictions as the reason for non-expansion, despite Missouri’s estimated $1.1 billion budget surplus for the 2021 fiscal year, well over the $120 million required for Medicaid expansion funding by the state. 

Fighting The Affordable Care Act In Court

Republicans left no stone unturned in their efforts to repeal the Affordable Care Act. While many lawsuits were filed, three made their way to the Supreme Court. Each time, the Affordable Care Act was found constitutional and upheld. 

National Federation of Independent Business v. Sebelius. In a 5-4 decision, with Chief Justice John Roberts siding with the majority, the court found the individual mandate requiring individuals to obtain health coverage constitutional. Republicans made the decision a rallying point for their base in the 2012 elections, vowing to repeal the law. 

King v. Burwell. In a 6-3 decision, the court found that Marketplace enrollees on both state-run and federal exchanges qualified for premium tax credits. In response, then House Speaker John Boehner declared, “ObamaCare is fundamentally broken, increasing health care costs for millions of Americans. Today’s ruling doesn’t change that fact…we will continue our efforts to repeal the law and replace it…”

California v. Texas. In a 7-2 decision, the court found that Republican-led states challenging the law had no standing to sue in the first place, because they had not been injured by the law. Continued calls for repeal and replace efforts were noticeably absent from Republican responses to the loss.