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Hundreds of Thousands of Ohioans Could Lose Health Care
during Pandemic
Trump administration, 18 states ask Supreme Court to end the
ACA
Despite the COVID-19 pandemic and recession, the Trump
administration and 18 state attorneys general filed briefs
asking the Supreme Court to strike down the entire
Affordable Care Act (ACA). If the lawsuit succeeds, hundreds
of thousands of Ohioans and their families who lost their
jobs and health insurance will lose options for coverage
through the ACA’s marketplace exchange or Medicaid
expansion. Hundreds of thousands of others who currently
receive coverage because of the ACA also would lose
coverage.
A Kaiser Family Foundation study estimates 1,002,000 Ohioans
and their family members lost employer-sponsored health
insurance in the first two months of the pandemic lock-down.
But essential economic security programs - the ACA and
Medicaid - protected most of them. Of those who lost
employer health coverage in the initial pandemic lock-down,
267,000 became eligible for premium tax credits to help
purchase coverage through the ACA’s health insurance
marketplace. Another 531,000 became eligible for Medicaid.
“Both the Medicaid expansion and the premium tax credits
that help moderate-income people afford private coverage
would be eliminated if the Supreme Court strikes down the
ACA,” said Wendy Patton, senior project director at Policy
Matters Ohio. “It is hard to imagine a worse time for state
leaders to actively work to reduce access to health care –
during a pandemic.”
The Supreme Court is likely to decide the case in the first
half of 2021, when the unemployment rate is still expected
to be about 10 percent and the public health crisis may
still be ongoing. If the court overturns the ACA, it would
not only hurt the newly unemployed, but also people and
families of low and modest income who have been getting
health care through Medicaid and the ACA marketplace plans.
The 628,000 low-income Ohioans insured through the Medicaid
expansion in April 2020 would all lose health coverage,
since the Medicaid expansion is part of the ACA. The 196,806
Ohioans enrolled in ACA marketplace plans in 2020 before the
pandemic started would also lose coverage.
Research shows the ACA has increased the number of people
with health coverage, made people more financially secure,
and improved people’s health – with strong evidence that
both Medicaid expansion and coverage through ACA
marketplaces save lives. Reversing these coverage gains
could worsen all of these outcomes. The adverse effects
would be even greater with more people depending on the ACA
for coverage during the recession.
The ACA also significantly narrowed racial disparities in
health coverage, and the lawsuit would widen them. Based on
pre-crisis estimates, repeal would cause nearly 1 in 10
non-elderly Black people, and 1 in 10 non-elderly Hispanic
people, to lose their health insurance, compared to about 1
in 16 white people.
Coverage losses from the lawsuit would also lead to spikes
in uncompensated care costs that would add to the financial
burden on state and local budgets during an unprecedented
state budget crisis. Caring for people without being paid
would harm providers at a time when many
will likely still be reeling from the large drop in their
revenues due to the pandemic. Uncompensated care costs as a
share of hospital budgets in Ohio fell by 49 percent as the
ACA’s major coverage provisions took effect. COVID-19 is
threatening the survival of some safety net and rural
hospitals: If the cost of uncompensated care rises, the
health care system that serves all Ohioans may be weakened.
Meanwhile, striking down the ACA would also eliminate other
policies and protections important to addressing and
recovering from the public health crisis. Once again,
insurance companies could charge higher premiums for Ohioans
with pre-existing health conditions – including COVID-19 –
or deny them coverage altogether. Insurance companies would
no longer have to cover preventive services, including
vaccines, without cost-sharing, and could go back to putting
annual and lifetime limits on coverage.
“The damage this lawsuit would impose on Ohioans is
devastating,” said Patton. “It is disdainful and
disrespectful of the lives of working people and families.”
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