Our view: A pandemic is no time to do away with the ACA
It is not hard to see the cruelty and incompetence in President Donald Trump’s response to the coronavirus pandemic: his repeated efforts to downplay its significance, his badgering of state leaders trying to act responsibly, his refusal to wear a mask in public, his touting of risky miracle cures and his reckless campaign rallies, to name a few.
But perhaps nothing matches this: In the middle of America’s worst health crisis in more than a century, the Trump administration is asking the Supreme Court — yet again! — to strike down the Affordable Care Act.
Such an action would mean the end of health coverage for about 20 million people who buy insurance on exchanges created by the ACA. It would also deprive millions who have recently lost their employer-sponsored coverage of the option to purchase coverage on the ACA marketplaces.
The decade-old law, moreover, is the only thing that requires insurers to sell coverage to people with preexisting conditions, which likely will include many thousands who will have ongoing health issues from COVID-19. If the law is struck down, the nation will head back toward the era when millions were barred from buying coverage at any price.
Not to worry, say Trump and Republican attorneys general seeking to have the high court kill the ACA. If that happens, they promise they will replace the despised act with something better, something that would protect people with preexisting conditions. But in 10 years of railing against the ACA, Republicans have yet to put forth a plausible alternative, and they show no sign of coming up with one now.
The ACA, also known as Obamacare, is a practical, if imperfect, law that expanded Medicaid and allows people who don’t work for government or large companies to buy coverage for their families on state-run insurance exchanges. In the years since its enactment in 2010, the law has survived repeated efforts to repeal it, to have it struck down by courts or to undermine it through regulatory changes. Obamacare has endured because it filled a huge hole in coverage that existed before its passage.
The latest effort to kill it is based on Congress’ decision in 2017 to repeal the mandate that all individuals buy health coverage or face a penalty. “The entire ACA thus must fall with the individual mandate,” the Trump administration argued in its brief filed late last week.
This rickety legal argument has attracted a plethora of responses from health-related groups. Their principal argument could be summed up in three words: Don’t do it. AHIP, the trade association for the insurance industry, says, “Make no mistake: Invalidation of the ACA would wreak havoc on the entire health care system.”
Havoc is the last things the nation needs. The law shouldn’t die; it should be enhanced. A nationwide open enrollment period would provide a safety net for those who’ve recently lost employer-sponsored insurance along with their jobs. Congressional Democrats have made a series of useful proposals to shore up state exchanges.
Fortunately, the Supreme Court isn’t expected to rule on the Obamacare case until after November’s election. That will give voters time to reflect on whether to reelect a president with an irrational hatred of the law championed by his predecessor.