The U.S. Supreme Court heard oral arguments Tuesday in a case challenging the constitutionality of the Affordable Care Act (ACA). If the suit succeeds, as many as 105,000 Maine residents could lose health insurance — the highest percentage increase of uninsured in the country.
The case was brought by a coalition of Republican state attorneys general, two individuals and President Donald Trump. The plaintiffs allege that since a provision included in the 2017 GOP tax bill reduced the financial penalty of the law to $0, the individual mandate cannot be legally understood as a tax and the entire Act is therefore unconstitutional.
The case figured front-and-center in Justice Amy Coney Barret’s October confirmation hearings. Following her appointment, advocates warned that a 6-3 conservative majority on the court could mean that the legal team defending the ACA would face an uphill battle.
A threat to Mainers with pre-existing conditions
If the ACA is struck down, the requirement that insurers provide equal coverage for all individuals, whether or not they have pre-existing health conditions, is also in jeopardy. According to an analysis by the Center for American Progress, more than 544,000 non-elderly Mainers have a pre-existing condition.
Marie Follayttar, co-founder and executive director of Mainers for Accountable Leadership, is one of those people. She shared her story during a Tuesday press conference hosted by Protect Our Care Maine.
“My healthcare under the ACA is what allows me to function and to work. It’s pretty basic to me — without healthcare, without treatment, I was permanently disabled,” Follayttar said. “I fear, with reason, that if the ACA is struck down, I will not be able to continue working and that I will put all the success and productivity that I’ve been able to put into the world at risk.”
Some of the 8,000 Mainers who have contracted the coronavirus will likely also be considered to have a pre-existing condition, according to some health care experts.
Citing his own experience working as a family physician, Sen. Ned Claxton (D-Androscoggin) emphasized during the press conference that, with some businesses struggling to stay afloat during the pandemic, many of the 44,000 Mainers currently looking for work may have also lost their employer-provided insurance plans.
“Those people and all of us need more options for health insurance, not fewer,” Claxton said. “So, when you add those concerns together with how bad this timing is … in the middle of a pandemic, that is nonsensical.”
In a press statement Tuesday, Governor Janet Mills echoed this concern.
“As we fight the COVID-19 pandemic, the biggest threat to public and economic health in recent memory, affordable, high-quality health care has never been more important,” Mills said. “No one should have to worry that a visit to the doctor, the pharmacy, or the hospital could bankrupt themselves or their family.
“The Affordable Care Act is the law of the land, it has improved the lives of millions of people, including tens of thousands here in Maine, and the Supreme Court should put an end to this partisan attempt to take that away,” Mills added.
According to Protect Our Care, an additional 8,000 young Mainers are at risk of losing their insurance if the ACA, which guarantees young adults the right to stay on their parents’ insurance plans until the age of 26, is ruled unconstitutional.
The time to act is now
Follayttar called on concerned citizens to share their health care stories and demand that their lawmakers act to protect the ACA.
“The first thing we can always do is share our stories and organize. The election is over and the leaders in power are accountable [to] the people” Follayttar said. “It is incumbent upon [Senator] Susan Collins to take leadership and protect folks with pre-existing conditions outside of verbiage on the campaign trail and into legislative action. Mainers’ lives are at risk.”
Collins’ relationship with the ACA figured prominently in her bid for re-election this fall. Just months after breaking with most of her party with a vote to uphold the law in September, 2017, Collins cast a deciding vote in favor of a tax bill which did away with the individual mandate, setting the stage for the lawsuit. Collins has stated that she supports the legislation as it currently functions, without a penalty.
Sen. Angus King is also a staunch supporter of the ACA, and affirmed his opposition to the lawsuit in an October statement.
“The stakes are clear, and they couldn’t be higher — which is why I won’t stop fighting to protect the ACA and the healthcare of the hundreds of thousands of Maine people that rely on it,” said King, whose office has produced a series of videos highlighting the ACA’s positive impact in Maine.
Rep. Chellie Pingree also called on the Supreme Court’s nine justices to uphold the ACA in a Tuesday statement.
“As our nation battles a pandemic that has already taken more than 235,000 American lives, this law is more important than ever,” Pingree said. “With this lawsuit, Republicans are trying to strip away health care access for millions yet again — just weeks after forcing the partisan confirmation of a radical Supreme Court justice and, as always, without a replacement plan.”
Rep. Jared Golden also spoke out against the lawsuit, writing on Twitter, “Many Mainers may not even know that they have a pre-existing condition that could be excluded from coverage without the ACA. It’s not only asthma and diabetes, but COPD, obesity, and even pregnancy that could mean folks would no longer be guaranteed coverage.”
“I’m dedicated to keeping the ACA in place,” Golden added, “and working to make the improvements necessary to make coverage and care more affordable for Mainers.”
The court will not release its decision until early 2021. However, advocates might have reason to be optimistic: Roberts and Justice Brett Kavanaugh, both conservatives, signaled in their comments during arguments on Tuesday that they may be skeptical of the plaintiffs’ legal claims.
Photo: Mario A. Pena via Creative Commons
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