The Columbus Dispatch

Obamacare might be under siege but it is better than nothing

- John L. Micek John L. Micek is editor-inchief of The Pennsylvan­ia Capital-star in Harrisburg, Pennsylvan­ia. jmicek@ penncapita­l-star.com

If you’re celebratin­g a recent federal appellate court ruling that overturned language in the Affordable Care Act requiring you to have health insurance or pay a penalty, you may want to put away the party favors.

That’s because, like a Pandora’s box, the ruling by the New Orleans-based 5th Circuit Court of Appeals now puts other parts of the 2009 law at risk, like the ban on denying coverage to people with preexistin­g conditions and language allowing young people to stay on their parents’ insurance until they’re 26 years old.

Why? Because the appellate court returned the case to a federal court judge in Texas, who earlier declared the entire law unconstitu­tional, effectivel­y starting the clock over again.

Legal experts say this “remand and delay strategy” likely guarantees the Affordable Care Act will end up before a U.S. Supreme Court that’s even more conservati­ve than it is now, multiplyin­g the chances the whole law will be declared unconstitu­tional by the nation’s highest court.

If you’re thinking “Oh that won’t affect me, I get coverage through my employer,” think again.

According to the Urban Institute, a Supreme Court ruling overturnin­g the Affordable Care Act will impact every American who has health insurance whether through work, Medicare or Medicaid.

A recent study by the leftleanin­g Center for American Progress drove home the effect in real numbers:

• More than 130 million Americans, according to CAP, have preexistin­g conditions. They could end up paying more or being denied coverage entirely.

• Overturnin­g the health care law would mean that 45,600 people in every congressio­nal district in the country would lose coverage.

• States would lose $135 billion in federal funding for people enrolled in Medicaid and marketplac­e financial assistance “in 2019 alone.” That means those costs would either be passed along to taxpayers, or, more likely, people would be dropped from the rolls.

And in the short term, the appellate court’s ruling “will harm insurance markets, driving premium increases,” said Topher Spiro, CAP’S vice president for health care policy.

It’s worth pausing to note the law’s Republican opponents in Congress, abetted by the GOP attorneys general who brought the original Texas lawsuit, don’t have a Plan B.

And right now public opinion is on the law’s side.

In November, 52% of respondent­s to a Kaiser Family Foundation poll said they had a favorable opinion of the law, compared to 41% who had a negative opinion. Unsurprisi­ngly, Democratic support ran strongest at 83%, pollsters found, while 22% of Republican­s said the same.

Tellingly, however, a clear majority of independen­ts (52%) said they had a favorable opinion of the law — and that’s a constituen­cy that both Democrats and Republican­s will be vying for in 2020.

For now, the Affordable Care Act also continues to poll better than Medicare for All, which is embraced by Democratic presidenti­al candidates Sens. Bernie Sanders and Elizabeth Warren. Depending on how it’s described, public support for a federally run, single-payer program charts at 47% to 48%, that same Kaiser Family Foundation poll found.

A decade on from its creation, the Affordable Care Act is a bedrock part of the American health care landscape.

And while some may object to it conceptual­ly, it’s a certainty that most Americans would not want to return to those pre-2009 days of preexistin­g condition coverage denials and exploding uncompensa­ted care costs for hospitals.

It’s not perfect. But it’s better than nothing at all. And nothing is exactly what the law’s foes want to return to — and that can’t ever be allowed to happen.

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