Obamacare fears after RBG death

Millions of US Covid-19 sufferers’ health care at risk

With Covid-19 the newest pre-existing condition, the Obama-era health law that protects Americans from insurance discrimination is more fragile following the death of Justice Ruth Bader Ginsburg.

A week after the presidential election, the Supreme Court is scheduled to hear arguments on an effort backed by President Donald Trump to strike down the Affordable Care Act, or ACA, in its entirety. Former President Barack Obama’s landmark law bars insurers from turning away people with health problems, or charging them more.

With Ginsburg on the court, there seemed to be little chance the lawsuit could succeed, given that she and four other justices had twice voted to uphold important parts of the health law. But that five-four majority is gone following Ginsburg’s death. Yet it is not clear what the court will do. A narrow ruling might leave most of the law intact, sparing protections

for people with pre-existing conditions, Medicaid expansion, health insurance subsidies and other core elements.

Nonetheless, House Speaker Nancy Pelosi has accused Trump of wanting to rush a conservative replacement through so he can accomplish his vow to repeal “Obamacare”.

“There are many, many people in our country — and millions more now because of coronavirus — who have pre-existing medical conditions,” she said. “The president has not been

truthful in what he has said about that. He is in court to crush the preexisting condition as he crushes the Affordable Care Act, instead of crushing the virus.”

Preserving safeguards for people with pre-existing conditions is a top argument for Democrats trying to mobilise public opinion in states where incumbent Republican senators face tight re-election challenges. It’s one the few avenues Democrats have to try to block a Supreme Court nominee in the GOPcontrolled chamber.

Back in 2017, failed Republican bills that sought to replace the Obama law would have weakened the health law’s protections for people with medical problems, said analyst Larry Levitt of the nonpartisan Kaiser Family Foundation. “It’s become like motherhood and apple pie to protect people with pre-existing conditions, but there is a big gap in the campaign slogans and what [Republicans] are willing to support,” said Levitt. “President Trump has promised to protect people with pre-existing conditions, but has yet to put out a plan.”

The ACA provides coverage to more than 20 million people through a combination of expanded Medicaid and subsidised private insurance. Coverage has grown as people have lost job-based coverage in the coronavirus pandemic.

The latest case to threaten the health law rests on arcane arguments. The lawsuit followed congressional approval of a major tax cut in 2017, which included the reduction of an Obamacare tax on the uninsured to zero. The suit argued that without the tax, the health law’s requirement that most Americans carry health insurance was unconstitutional. Therefore, the entire statute must fall.

A federal district court judge in Texas agreed with the Obamacare foes. But an appeals court in New Orleans struck down the ACA requirement to carry insurance, but sidestepped a decision on the constitutionality of the law. The appeals court sent the case back to the district judge. ACA supporters appealed to the Supreme Court.

The Trump administration argues that if the health insurance requirement is invalidated, “then it necessarily follows that the rest of the ACA must also fall”. The administration’s brief to the Supreme Court did not mention the coronavirus. — AP