Last month, the Fifth Circuit Court of Appeals ruled in favor of the Trump administration and Republicans in Texas vs. United States, striking down as unconstitutional the ACA’s individual mandate and remanding to the lower court judge a final decision on what parts of the ACA should be eliminated – the very judge who has already ruled the entire law unconstitutional. If President Trump and Republicans have their way, 20 million Americans will lose their insurance coverage, 135 million Americans with pre-existing conditions will be stripped of their protections, and costs will go up for millions. 

“The Fifth Circuit’s disastrous decision on President Trump’s Texas lawsuit puts the health care of millions of Americans at risk. The court’s decision will impact every corner of the American health care system, making the high cost of prescription drugs even worse and threatening health care access for children, seniors, women, individuals with disabilities and LGBTQ Americans in communities across the country,” said Protect Our Care Executive Director Brad Woodhouse. “Over the course of these days of action, we will be reminding Americans what’s really at stake if the courts ultimately overturn the health care law.” 

Days of Action: Day 8 of 11 focuses on Prescription Drug Costs. To learn more about our Days of Action, visit our website.

What’s At Stake: Prescription Drug Costs

If the ACA is overturned, the high cost of prescription drugs would only get worse:  

  • GONE: Rules that increase competition in the prescription drug market and help Americans access cheaper drugs. 
  • GONE: Consumer protections that prohibit drug companies from paying off doctors behind closed doors to influence the drugs they prescribe to patients.
  • GONE: Nearly 12 million seniors will have to pay more for prescription drugs because the Medicare ‘donut hole’ will be reopened.

ACA Repeal Means More Profits For Drug Companies And Higher Costs For Consumers. 

Consumers could be forced to pay more for drugs. The ACA’s Biologics Price Competition and Innovation Act paved the way for the Food and Drug Administration (FDA) to approve biosimilars, cheaper alternatives to expensive biologics. Without the ACA, approval of biosimilars will be in jeopardy, and drug companies may be less likely to invest in new biosimilar drugs. This change will make it harder for Americans to access low-cost alternatives to expensive biologic medications. It will also jeopardize the predicted $54 billion in savings that biosimilars are expected to produce between 2017 and 2026.

Drug companies would once again be allowed to pay doctors behind closed doors (to prescribe drugs you don’t necessarily need). Without the ACA’s Physician Payments Sunshine Act, Big Pharma will once again be allowed to make payments and offer gifts to doctors behind closed doors. When these payments are made with no transparency, they can create conflicts of interest and blur the line between objective and promotional research. The outcome of the Texas lawsuit has the potential to uproot the health care system all while giving drug companies even more power. 

Reopening the “donut hole” would make medications more expensive for 12 million seniors. If the entire ACA is overturned, seniors will have to pay more for prescription drugs because the Medicare “donut” hole will be 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