The Supreme Court's hearing of arguments this week boded well for defendants of the health care law, with Chief Justice John Roberts and Justice Brett Kavanaugh signaling support for keeping the law. (Photo: Shutterstock)
With Joe Biden's presidential election win, the next four years have started to look a little clearer. There are still a couple of wildcards up in the air, however, most notably the fate of the Affordable Care Act. A landmark piece of legislation during his tenure as vice president, Biden might instead start his term picking up the pieces and build anew should the Supreme Court strike the entire law down.
The loss of the ACA would have far-reaching effects, not only on individuals relying on the law's protections for pre-existing conditions but employers, health insurers and health care systems.
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"Let's be absolutely clear about what's at stake: The consequences of the Trump administration's argument are not academic or an abstraction. For many Americans, they are a matter of life and death, in a literal sense," president-elect Joe Biden said in a speech in Wilmington, Delaware. "This isn't hyperbole. It's real — as real as it gets."
The Supreme Court's hearing of arguments this week boded well for defendants of the health care law, with Chief Justice John Roberts and Justice Brett Kavanaugh signaling support for keeping the law without the individual mandate, though the final outcome is yet to be determined.
Meanwhile, supporters of the law have plenty to say about its impact and what a loss would mean for the country.
Salvation for small businesses
Various members of the Main Street Alliance shared how the ACA has been instrumental in their lives during a recent call:
"As small business owners, my wife and I don't have the option of employer-provided-health insurance. And, because both of us have pre-existing conditions, private insurance is out of the question, too. The ACA doesn't allow our pre-existing conditions to disqualify us from coverage," said Bob Goodman, Owner of Robert Goodman Jewelry in Zionsville, Indiana. "The attacks on the ACA harm business owners and consumers alike. These costs limit the money we can put into both our business and the economy."
"To live or not to live should not be a budget line item," added Leonardo Williams, owner of Zweli's Kitchen in Durham, North Carolina. "Another reason these costs have gone up is that the price of prescription drugs is rising faster than any other good or service. The Supreme Court Case is another attack on my ability to get health insurance or provide it for my staff. We are hoping to subsidize their health plans on the marketplace – if that goes away I've lost my ability to provide health care for my staff – we are too small for a single employer-based plan to make any sense."
Lasting repercussions
"The investment employers have already made (and would have to make) in devising plans that comply with the ACA and in compliance with the law's reporting requirements, state governments who have implemented their own mandates, and health insurers whose operations would be irretrievably altered, said Kim Buckey of DriectPath. "Repealing the ACA would take months, if not years, to unwind.
"While these issues are likely not top of mind for the Supreme Court as it considers the case, it is encouraging that, based on today's hearings, the majority of Justices do not appear convinced that the entire ACA must be scrapped because the mandate is unconstitutional. We will have to continue to watch this case closely, however, as unless the mandate is ultimately considered constitutional or the Court dismisses the case, there will be at least some downstream impact of any decision."
"We concur with the initial reaction from the legal community that, based on oral argument, it seems less likely that the Supreme Court will strike down the entire Affordable Care Act," Brady Bizarro, Esq., director of legal compliance and regulatory affairs for The Phia Gropu said via email. "It does seem to us that the challengers (the "Respondents") will prevail on their first two arguments: that they have standing to pursue the case to begin with, and that the zeroing out of the tax penalty made the individual mandate unconstitutional. Their third argument, however, is key because that argument calls for invalidating the rest of the healthcare law. Based on the Court's prior rulings, it is never wise to read too much into oral argument. The Court could come down another way next spring."
Critical in a crisis
"We are encouraged by the thoughtful questions raised by the Justices in today's arguments and are confident that the Court will come to the right decision to uphold the law and sustain the ACA's important consumer protections," America's Health Insurance Plans said in a statement. "Invalidating the law would be misguided and wrong and unleash chaos on the entire health care system. For Americans with pre-existing conditions, worrying about their health can be constant. Worrying about whether they will have coverage for their health conditions should not be."
"Blue Cross and Blue Shield companies believe everyone should have access to health care, no matter who you are, where you live or what your health status may be," said BCBS president and CEO Scott P. Serota. "The U.S. Supreme Court should not invalidate the Affordable Care Act. To do so would strip vital protections from consumers no matter where they get their health insurance coverage – through an employer, Medicare and Medicaid, or the individual marketplaces that were created under the law. The ACA is particularly critical now for millions of the newly unemployed and their families, ensuring they still have access to quality and affordable health insurance coverage during a severe public health crisis."
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Emily Payne
Emily Payne is director, content analytics for ALM's Business & Finance Markets and former managing editor for BenefitsPRO. A Wisconsin native, she has spent the past decade writing and editing for various athletic and fitness publications. She holds an English degree and Business certificate from the University of Wisconsin.
