The ACA meets COVID-19: Now What?

Before the Affordable Healthcare Act (ACA), 44 million Americans were uninsured. While the Affordable Care Act (ACA), passed in 2010, improved the provision and delivery of healthcare to over 16 million Americans, there are still gaps in coverage. Since its rollout, the ACA has faced several legal challenges including a lawsuit filed in 2016 against Sylvia Burwell, the HHS Secretary during the Obama Administration. This initial challenge sparked a nationwide injunction against certain ACA provisions. In what has been known as the landmark ACA case, U.S. v. Texas, 20 states sought to strike down the entire Act after challenging the individual mandate to maintain health coverage each tax year that was enacted following the passage of the Tax Cuts and Jobs Act of 2018 ( under the Trump Administration). The Supreme Court is expected to make its final ruling later this year as to whether ACA, in its entirety, will be upheld.

The COVID-19 crisis further complicates the ACA issues. A vaccine is likely not going to be available for the next year or so, meaning it will be available only after the Supreme Court will make its decision. Experts suspect that overturning the ACA will cost many Americans their insurance benefits, which limits their access to vaccines (when available), leaving Americans vulnerable to the continued spread of the virus. High-ranking elected officials view the continued pursuit of some courts to strike down the ACA as  “unconscionable” during a public health emergency such as this. 

Lawmakers are split on their views of the ACA in the wake of the 2020 Pandemic. Democratic lawmakers have expressed concerns over the problems that gaps in coverage will have on the spread of COVID-19, while Republican lawmakers have upheld their contention that Americans’ previously demonstrated intent to seek alternatives to ACA health plans, negates arguments that ACA should re-open enrollment. A House Republican further noted that coronavirus testing is free and the Administration reports that many states continue to expand Medicare to cover those experiencing loss of jobs and health coverage. 

In contrast to what Republican lawmakers presented in the ACA debate, nine states (Colorado, Connecticut, Maryland, Massachusetts, Nevada, New York, Rhode Island, and Washington) have made it possible for its citizens to obtain some form of medical coverage during the COVID-19 crisis. Typical of most insurance plans, individuals and families can only elect coverage during open enrollment once a year without a qualifying status change. Nonetheless, these nine states have created a special enrollment for citizens or extending the current open enrollment period. Insurers are supportive of these states and are looking for ways to mitigate any risks associated with new enrollees during the Pandemic.

Kaiser Family Foundation describes the use of ACA health plans as a safety net during the Pandemic that can be used by Americans who have lost wages due to reduced hours or business closings. Subsequent limits on health coverage may cause some to delay care which harms the health of the community. KFF further reports substantial out-of-pocket expenses for those hospitalized. The report insists that gaps in coverage will cause some people to delay treatment which could have serious consequences as the country tries to reduce the number of new or undiagnosed COVID-19 infections. As the ACA moves closer to its final day in court and the COVID-19 continues as a pandemic lawmakers are now asked to consider whether the health of the nation should suffer as a result of political turmoil.

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