Recent events have thrown the future of the 2010 health care law, known as the Affordable Care Act (ACA), in limbo. This threatens health coverage for millions of Americans, including thousands of Delawareans.
In 2012, the Supreme Court upheld the ACA based on Congress’ taxing authority, essentially interpreting the “individual mandate,” the portion of the law requiring every individual to sign up for health coverage or face a penalty, as a tax that was well within the authority of Congress to impose. In late 2017, Congress reduced the penalty to $0. Late last year, a federal judge in Texas ruled that the entirety of the ACA was invalid as the individual mandate could no longer be considered a tax, rendering the ACA unconstitutional in his opinion.
Recently, the Trump Administration’s Justice Department signaled in a court filing that the Administration sided with the Texas decision and agreed that the entire law should be invalidated.
If the ACA were overturned, it would be a big setback for coverage in America and result in hardship and worsening health. At great risk would be:
The 23 million Americans whose health coverage is a direct result of provisions in the ACA.
The 11.4 million Americans who purchase health insurance on the health exchange marketplace set up by the ACA. This includes more than 22,000 Delawareans.
The roughly 25,000 Delawareans covered as a result of the Medicaid expansion through the ACA.
Children who can now remain on a parent’s health insurance plan up to age 26.
With less people covered by health insurance, non-profit providers (all of Delaware’s general acute care and pediatric hospitals are non-profit) will see their uncompensated care costs increase for the newly uninsured by as much as $50.2 billion, according to the Urban Institute. This will put cost pressure on private insurance rates to fill the gap.
What has the ACA meant for Delaware? It has meant success in providing more insurance coverage for more people and better health. The uninsured rate in Delaware dropped from 9.1 percent in 2013 to 5.4 percent in 2017 as the ACA was implemented. People with insurance tend to see their doctors more frequently and address ailments earlier than those without insurance. The ACA has meant better health for countless of our neighbors and friends in Delaware.
The Delaware Healthcare Association’s (DHA) mission is to create an environment for enabling every Delawarean to be as healthy as they can be. Having access to health insurance is a big part of creating a healthy environment.
The law is part of the American health care landscape. It can certainly be improved, but that is where the effort needs to be, not in repeal.