When the Patient Protection and Affordable Care Act (ACA) was signed into law in 2010, millions of disabled Americans, myself included, breathed a sigh of relief.
Finally, we no longer would be punished for illnesses outside of our control. No longer would we face higher costs or coverage lockouts due to preexisting conditions. No longer would we struggle to find plans that actually cover essential health benefits like mental health services, prescription drugs, hospitalization and rehabilitative services. No longer would we face annual or lifetime caps if our life-sustaining care cost insurance companies too much.
Unfortunately, that sense of relief did not last long. The ACA was immediately subject to legislative and legal challenges. For years, patients have fought against attempts to undo the protections that barred discrimination against people with chronic illness, mental illness and a variety of other disabilities. Now, with another pending legal challenge heard by the Supreme Court this week, the disabled community is again fighting to protect our care and grappling with the risk to our health.
I have several chronic health issues, and I get my insurance through the healthcare.gov marketplace like more than 200,000 other Utahns. I lose sleep at night over the thought of going back to the years I spent uninsured, sick and scared. And I am far from alone. More than 68,000 Utahns have gained coverage through our new Medicaid expansion, and up to 1.2 million Utahns have preexisting conditions that could mean higher costs or other barriers to care if the Supreme Court overturns the Patient Protection and Affordable Care Act.
If you listened to the Senate Judiciary Committee confirmation hearings for Justice Amy Coney Barrett, you heard a lot of back and forth over the ACA repeal case — with Democrats showcasing stories of their constituents who fear for their health care, and Republicans promising that the court would never actually accept the premise of the case and surely would never overturn the Affordable Care Act. Except, that is exactly what the Trump administration and 18 state attorneys general, including Utah’s Sean Reyes, are asking for: full repeal of the law and all of its benefits, as the plaintiffs made clear in this week’s Supreme Court oral arguments.
Make no mistake — truly covering preexisting conditions is not easy. To protect Americans, there must be more than empty promises — it takes a comprehensive web of policies to ensure that we are protected in reality and not just in theory. That means that even if the Supreme Court relies on “severability,” and repeals only a few select provisions rather than the entire law, disabled people and other people with preexisting conditions could still be at risk.
Having read the 900-plus page health care law, I like to say that it is that lengthy for a reason. Health care is complicated! Protecting patients is complicated.
The Affordable Care Act has meant significant progress for Americans with health care needs. After 10 years in place, it is a critical part of our health care system and repealing even small parts of it could have devastating consequences. We can’t go back. There is too much at stake. Rather than continuing meritless legal challenges, our elected officials should build on the promise of the Affordable Care Act.
Stacy Stanford, Salt Lake City, is a longtime disability justice advocate and health policy analyst at Utah Health Policy Project.