Whether the Affordable Care Act stays, goes or is significantly changed will affect the way life is lived in the US.
The argument against the law from the Trump administration and conservative states is that the 10-year-old statute was rendered unconstitutional in its entirety when Congress dialed down to zero a penalty on those remaining uninsured.
The court has shifted solidly to the political right under President Donald Trump.
Here’s a look at some of what’s at stake if the opponents of the law prevail:
COVID-19 A NEW PRE-EXISTING CONDITION
COVID-19 would become America’s newest pre-existing condition, for more than 10 million people who have tested positive so far.
Under the ACA, a coronavirus case cannot be used to deny someone coverage or charge them more. If Obamacare is gone, that becomes a real question. Trump promised to always protect people with preexisting conditions, but never said how he’d do it.
COVERAGE FOR MORE THAN 20 MILLION
The ACA’s two main programs for covering uninsured people would be wiped out if the law is overturned, leaving more than 20 million people uninsured unless a divided Congress can put a new safety net in place.
Most American women now pay nothing out of their own pockets for birth control. That’s covered as a preventive service, free of charge to the patient, under the ACA.
Many other services, from colonoscopies to flu shots, are also free. That could change.
RETURN OF A MEDICARE GAP
Repealing the ACA would mean the return of the coverage gap, sure to infuriate older voters, many of whom say their medications still cost too much.
LONGER RUNWAY SHORTENED
One of the earliest benefits to take effect after the passage of “Obamacare” was a requirement that insurers allow young adults to stay on a parent’s plan until they turned 26.
That provided a longer economic runway for millions of young adults, who back then were struggling with the lingering effects of the Great Recession. Nowadays it’s the consequences of the coronavirus economy.
TAX CUT FOR THE WEALTHY
“Obamacare” raised taxes on upper income individuals to help finance its coverage expansion.
If the entire law is repealed, that would deliver a tax cut to well-to-do people, many of whom have escaped the economic shock of the COVID-19 pandemic because stock market investors have continued to do well.