Intro: On May 6th the Supreme Court Begins Consideration of the Texas Lawsuit As The Nation Fights Coronavirus

This packet has resources to support your communications to constituents and the media on the disastrous implications on the Trump Texas lawsuit to repeal the Affordable Care Act, particularly in the middle of the coronavirus crisis.  

Supreme Court Activity In Trump’s Lawsuit To Overturn The Affordable Care Act Begins Next Week 

On May 6th the Supreme Court begins its consideration of the case, when the House of Representatives and Democrat Attorneys General submit briefs defending the law.  Oral arguments are expected before the November election. Health care, particularly during the pandemic, remains the number one issue for Americans and the Texas lawsuit is the most powerful example of the Republican war on America’s health care.  

The best way to highlight the threat is by explaining just how devastating ripping health care away from 20 million Americans would be when tens of millions have already lost their employer-based health coverage and how outrageous it is to rip protections for 135 million Americans with pre-existing conditions would be as this pandemic rages, especially when everyone who contracts coronavirus could later be denied coverage as a result.

As always, it’s critical to uplift voices of those who have benefited from the law and those who will suffer if it is overturned. This includes the 135 million Americans with pre-existing conditions whose protections would be ripped away if the law is overturned. Or someone who has tested positive for coronavirus and could now be considered to have a pre-existing condition by insurance companies. Or how anyone who has received coverage under Medicaid expansion would lose that coverage if the law is overturned.  These stories are essential in making the reality of this situation clear to the press and the public that taking away this law in the midst of the pandemic would be cataclysmic for Americans’ health care.

If you’d like to work with Protect Our Care in your district, contact Anne Shoup at [email protected]. 

How We Got Here:

Republicans in Congress have tried and failed dozens of times to repeal or weaken the Affordable Care Act and since day one of his presidency, Donald Trump has done everything in his power to sabotage and undermine the law. When he failed in Congress to overturn it, the president and Republican attorneys general turned to the courts. That case, Texas v. United States, is now before the Supreme Court, and on May 6, Democratic attorneys general and the House of Representatives will submit their briefs urging the court to reject the disastrous Trump-Republican lawsuit and protect the health care of millions of Americans. On May 13, health care experts, patient advocacy groups and others will file their briefs in opposition to the lawsuit. And in June, Republican states and the Trump administration will submit their briefs in response. The case will then be argued before the Supreme Court in its next term, quite possibly before the election in November. 

The submission of these briefs from Democratic states next week will put the Trump administration’s politically-motivated lawsuit on full display for the American people in front of the highest court. And as this case comes back into focus, it’s especially important that Americans understand just what’s at stake if the law is overturned, particularly in the midst of a global pandemic.

The Trump Lawsuit Will Make the Coronavirus Crisis Far Worse

Simply put, there has never been a more important time to protect and expand Americans’ health care, and never been a worse time to rip it away. As the Trump administration and state Republicans present their case for doing just that, Democrats next week will put into stark terms why the Trump-Republican lawsuit is not only cruel, but disastrous for our country during this crisis at a time when people need health care the most. 

No action would be more damaging to Americans’ health and safety than if the Trump administration achieves their desired goal of overturning the ACA in its entirety during this crisis. When the court hears this case, there will likely be no vaccine and no viable treatment for the virus. When millions of Americans have already lost health insurance due to the pandemic, it’s absurd that President Trump is arguing in court that 20 million more Americans should lose their health care. And when millions of Americans with the coronavirus join the 135 million Americans with a pre-existing condition, President Trump will also be arguing in court to allow insurance companies to deny them coverage or charge them more. 

At a time when we should be taking aggressive action to protect and expand health care for all Americans, like fully expanding Medicaid, opening a special enrollment period for the uninsured, or increasing financial assistance for people purchasing insurance, the Trump administration is instead arguing in court that the entire law should be overturned and programs like Medicaid expansion — which has covered millions more Americans — should be eliminated. If the Trump administration is serious about protecting Americans they would drop this lawsuit, yet sadly they have demonstrated that their desire to destroy the law trumps the health and safety of our nation.

Supreme Court Will Decide Fate Of Trump-Texas Lawsuit In Upcoming Term

In March, the Supreme Court granted cert in the Trump-Republican lawsuit to overturn the Affordable Care Act. This means arguments will likely be held next fall–just as voters prepare to cast their 2020 ballots. If President Trump and his allies are successful, 135 million Americans with pre-existing conditions will lose protections and 20 million Americans will lose coverage. Every serious legal scholar agrees that this Trump-Republican lawsuit is entirely without merit. Every Republican who claims to care about health care should tell the president to drop this lawsuit.

New POC Poll Found That Less Than 30 Percent Of Voters Support Trump’s Lawsuit To Overturn The ACA. While more than half of voters oppose Trump’s lawsuit to strike down the ACA, only 29%–and just 44% of Republicans–support the lawsuit.

Fact Sheet On Trump Lawsuit To Overturn ACA

President Trump is trying to rip apart our health care by going to court to eliminate the Affordable Care Act in its entirety. If the Trump lawsuit is successful, it will strip coverage from millions of Americans, raise premiums, end protections for people with pre-existing conditions, put insurance companies back in charge, and force seniors to pay more for prescription drugs. The result will be to — as the Trump Administration itself admitted in Court — unleash “chaos” in our entire health care system. 

If the Affordable Care Act is struck down:

• GONE: Protections for 135 million Americans with pre-existing conditions. The uninsured rate will increase by 65 percent. 
• GONE: Medicaid expansion, which covers 17 million people. 
• GONE: Nearly 12 million seniors will have to pay more for prescription drugs because the Medicare ‘donut hole’ will be reopened.
• GONE: 2.3 million adult children will no longer be able to stay on their parents’ insurance. 
• GONE: Insurance companies will be able to charge women 50 percent more than men.
• GONE: Financial assistance that helps 9 million people purchase health care in the marketplace.
• GONE: Key support for rural hospitals. As Americans lose coverage, already struggling hospitals will be hit even harder as their costs increase.
• GONE: Ban on insurance companies having lifetime caps on coverage.
• GONE: Requirements that insurance companies cover prescription drugs and maternity care.

Thanks To The Republican Lawsuit, 20 Million People Could Lose Their Coverage

• According to the Urban Institute, 19.9 million people could lose coverage by repealing the Affordable Care Act, meaning the number of uninsured Americans would increase from 30.4 million to 50.3 million, representing a leading to a 65 percent increase in the uninsured rate. As the uninsured rate swells, so will the amount of uncompensated care, which Urban predicts will grow by at least 82 percent.
• States would lose important federal health care funding — an estimated reduction of $135 billion in the first year. The Urban Institute estimates that a full repeal of the ACA would reduce federal spending on Medicaid/CHIP care and Marketplace subsidies by $135 billion, or 34.6 percent in the first year.
• Millions of children could lose their coverage. Almost three million children nationwide gained coverage thanks to the ACA. If the law is overturned, many of these children will lose their insurance.
• The percentage of people gaining health insurance under the ACA was higher for Latinos than for any other racial or ethnic group in the country. According to a study from Families USA, 5.4 million Latinos would lose coverage if the lawsuit succeeds in overturning the ACA. 

Republicans Want To Put Insurance Companies Back In Charge, Ending Protections For The 135 Million People With A Pre-Existing Condition

• According to a recent analysis by the Center for American Progress, roughly half of nonelderly Americans, or as many as 135 million people, have a pre-existing condition. This includes:
  • 44 million people who have high blood pressure
  • 45 million people who have behavioral health disorders
  • 44 million people who have high cholesterol
  • 34 million people who have asthma and chronic lung disease
  • 34 million people who have osteoarthritis and other joint disorders

• More than 17 million children, 68 million women, and 32 million people aged 55-64 have a pre-existing condition.

Republicans Want To Give Insurance Companies The Power To Deny Or Drop Coverage Because Of A Pre-Existing 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. Now insurance companies have license to do this again.

• A 2010 congressional report found that the top four health insurance companies denied coverage to one in seven consumers on the individual market over a three year period. 
• A 2009 congressional report found that the of the largest insurance companies had retroactively canceled coverage for 20,000 people over the previous five year period
• An analysis by Avalere finds that “102 million individuals, not enrolled in major public programs like Medicaid or Medicare, have a pre-existing medical condition and could therefore face higher premiums or significant out-of-pocket costs” if the Trump-GOP lawsuit is successful.

Republicans Want To Give Insurance Companies The Power To Charge You More, While Their Profits Soar

• 138 Million Americans Could Once Again Have To Pay For Preventive Care. Because of the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no cost to consumers. This includes nearly 138 million Americans, most of whom have employer coverage.
• Premium Surcharges Can Once Again Be In The Six Figures. Thanks to the Republican lawsuit, insurance companies can charge people more because of a pre-existing condition. The House-passed repeal bill had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma, $17,060 more for pregnancy, $26,180 more for rheumatoid arthritis and $140,510 more for metastatic cancer.
• Women Can Be Charged More Than Men For The Same Coverage. Prior to the ACA, women, for example, were often charged premiums on the nongroup market of up to 50 percent higher than they charged men for the same coverage. 
• People Over The Age of 50 Can Face A $4,000 “Age Tax.” Thanks to the Republican lawsuit, insurance companies can charge people over 50 more than younger people. The Affordable Care Act limited the amount older people could be charged to three times more than younger people. If insurers were to charge five times more, as was proposed in the Republican repeal bills, that would add an average “age tax” of $4,124 for a 60-year-old in the individual market, according to the AARP.
• Nine Million People In The Marketplaces Will Pay More For Coverage. Thanks to the Republican lawsuit, consumers no longer have access to tax credits that help them pay their marketplace premiums, meaning roughly nine million people who receive these tax credits to pay for coverage will have to pay more.
• Seniors Will Have To Pay More For Prescription Drugs. Thanks to the Republican lawsuit, seniors will have to pay more for prescription drugs because the Medicare “donut” hole got reopened. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 Centers on Medicare and Medicaid Services report.

Republicans Want To Give Insurance Companies The Power To Limit The Care You Get, Even If You Have Insurance Through Your Employer

• Reinstate Lifetime and Annual Limits On 109 Million Privately Insured Americans. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage for those insured through their employer or on the individual market.
• Insurance Companies Do Not Have to Provide the Coverage You Need. The Affordable Care Act made comprehensive coverage more available by requiring insurance companies to include “essential health benefits” in their plans, such as maternity care, hospitalization, substance abuse care and prescription drug coverage. Before the ACA, people had to pay extra for separate coverage for these benefits. For example, in 2013, 75 percent of non-group plans did not cover maternity care, 45 percent did not cover substance abuse disorder services, and 38 percent did not cover mental health services. Six percent did not even cover generic drugs.
• Large Employers Could Choose to Follow Any State’s Guidance, Enabling Them Put Annual and Lifetime Limits on Their Employees’ Health Care. Without the ACA’s definition of essential health benefits (EHB) in even some states, states could eliminate them altogether. Large employers could choose to apply any state’s standard, making state regulations essentially meaningless. Because the prohibition on annual and lifetime limits only applies to essential health benefits, this change would allow employers to reinstate annual and lifetime limits on their employees’ coverage.

Republicans Want To End Medicaid Expansion

• Seventeen Million People Enrolled Through Medicaid Expansion Could Lose Coverage.
• Access To Treatment Would Be In Jeopardy For 800,000 People With Opioid Use Disorder. Roughly four in ten, or 800,000 people with an opioid use disorder are enrolled in Medicaid. Many became eligible through Medicaid expansion.
• Key Support For Rural Hospitals Would Disappear, leaving hospitals with $9.6 billion more in uncompensated care. 

Top Ways The ACA Helps Fight Coronavirus 

The Affordable Care Act is a critical tool to help the U.S. coronavirus response. If Trump is successful in overturning the law in court, we will lose key protections: 

• Coverage for 20+ Million People. Because of the ACA, more than 20 million Americans gained health coverage. People with insurance are much more likely to see a doctor when they are sick and to get the treatment they need. 
• Protections For 135 Million People With Pre-Existing Conditions. Thanks to the ACA, insurers can no longer deny or drop coverage because of a pre-existing condition. Anyone who contracts the coronavirus will not be subject to future discrimination from their insurance companies. 
• Free Preventative Care. Because of the ACA, health plans must cover designated preventive services — including screening tests without cost-sharing. 
• Comprehensive Coverage. Because of the ACA, insurers have to cover what are known as “essential health benefits,” such as prescription drugs and hospitalization. Coronavirus testing and treatment are essential health benefits and must be covered by all ACA-compliant plans.
• Access To Critical Vaccinations Without Cost Sharing. The Affordable Care Act will almost certainly cover the coronavirus vaccine without cost-sharing, because it requires plans to cover all vaccinations recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP). 
• Increased CDC Funding. The Affordable Care Act established the CDC Prevention and Public Health Fund, which helps states prepare for disease outbreaks. The Washington Post reported that this fund “provides almost $1 billion annually to CDC, now about 12 percent of CDC’s budget. It includes prevention of bioterrorism and disease outbreaks, as well as money to provide immunizations and heart-disease screenings.”
• Medicaid Expansion. Because of the ACA, states can get additional federal money to expand Medicaid to vulnerable populations. More than 17 million Americans now have coverage through Medicaid expansion. Importantly, Medicaid’s funding structure allows funds to increase in response to a public health emergency like coronavirus. 
• Key Support For Rural Hospitals. The ACA led to a $12 billion reduction in uncompensated care costs. Between 2013 and 2015, hospitals’ uncompensated care costs decreased by $12 billion, or roughly 30 percent. As hospitals prepare for an influx in patients, it is critical that they are paid for the treatment they provide.