We have reached a critical point for the future of American health care and the fate of the Affordable Care Act (ACA). On June 25th, Trump’s Department of Justice (DOJ) and Republican-led states submitted their briefs in support of California v. Texas, the lawsuit seeking to strike down the ACA. If President Trump and Republicans have their way, more than 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 consequences of the lawsuit for America’s health care are particularly devastating at a time the country is gripped by the coronavirus crisis which threatens the health and safety of the entire nation.

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 who contract 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. The submission of these briefs from Republican states will put the Trump administration’s politically-motivated lawsuit on full display for the American people in front of the highest court.

Days of Action: Day 12 of 12 focuses on health care for rural Americans. To learn more about our Days of Action, visit our website.

What’s At Stake: Rural Health Care

At a time when millions of people are facing the possibility of coronavirus and devastating health care bills, protecting coverage under the Affordable Care Act is more important than ever. Overturning the ACA would be particularly devastating for rural communities, which are seeing a rise in coronavirus cases nationwide and where the law’s Medicaid expansion plays a pivotal role in supporting rural hospitals and fighting the opioid crisis. 

Rural Americans Stand To Lose If The Texas Lawsuit Overturns The ACA:

  • Nearly 1.7 million rural Americans gained coverage through Medicaid expansion under the ACA. 
  • 24 percent of Americans living in rural areas have health coverage through Medicaid. The uninsured rate for low-income adults dropped from 35 percent to 16 percent in rural areas and small towns in states that expanded Medicaid.
  • In 2017, nearly 1 in 5 marketplace enrollees (1.6 million people) lived in rural areas.
  • Rural Americans are more likely to be uninsured than Americans living in non-rural areas.

Medicaid Is A Lifeline For Rural Hospitals: 

  • The Affordable Care Act 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. The majority of this reduction was concentrated in states that chose to expand Medicaid.
  • 430 rural hospitals are at a high financial risk of closing. This represents roughly 21 percent of the country’s rural hospitals.
  • 120 rural hospitals have closed since 2010. The vast majority closed in states that had not expanded Medicaid at the time of the hospital closure.

American Hospital Association, Federation Of American Hospitals, The Catholic Health Association Of The United States, And Association Of American Medical Colleges: “A Judicial Repeal Would Have Severe Consequences For America’s Hospitals, Which Would Be Forced To Shoulder The Greater Uncompensated-Care Burden That The ACA’s Repeal Would Create.” [American Hospital Association et. al, 6/14/18]

The ACA’s Medicaid Expansion Plays A Central Role In Fighting The Opioid Crisis

  • In 2014, Medicaid paid for 25 percent of all addiction treatment nationwide.
  • It is estimated that Medicaid expansion covers four in ten people with an opioid use disorder. More than half of people with an opioid use disorder earn incomes below 200 percent of the federal poverty line.
  • Among those with opioid addiction, people covered through Medicaid are more than twice as likely as those with private insurance or no insurance to receive treatment. In 2016, 43 percent of people who had substance use disorders received treatment when they were covered through Medicaid, significantly higher than the 21 percent of those privately insured who received treatment and 23 percent of those who were uninsured and received treatment.
  • Medicaid expansion has reduced unmet need for substance use treatment by more than 18 percent. Recent research finds that Medicaid expanding reduced the unmet need for substance use treatment by 18.3 percent.