What’s at stake in the Supreme Court’s ACA case? A quick explainer

From Medicare drug costs to health insurance for the newly jobless, a wide range of programs could be upheld or overturned
Michigan Medicine - University of Michigan

Newswise — Though the election and pandemic have eclipsed it in the news, there’s another event unfolding this month that could affect nearly all Americans: a Supreme Court case that will decide the future of the Affordable Care Act.

On Tuesday, Nov. 10, lawyers will argue before the court’s nine justices that the ACA should be overturned or upheld, in a case called California v. Texas. The ACA has been law for 10 years, and has had far-reaching effects on nearly every aspect of American health care, research has shown.  

The case hinges on an arcane bit of law, and the court may not rule until spring. Depending on the outcome of the election for the U.S. Senate, there may also be a chance for a “fix” that could make a ruling against the ACA moot.

No matter what the ultimate outcome, the case matters to nearly every American, says a University of Michigan primary care physician and health policy researcher.

In the brief video above, Renuka Tipirneni, M.D., M.Sc., explains those potential effects in a nutshell.

She’s a general internist at Michigan Medicine and member of the U-M Institute for Healthcare Policy and Innovation, home to hundreds of researchers who measure and report on the effects of the ACA’s major programs.

Tipirneni helps lead a team that has focused on evaluating the effects of the Healthy Michigan Plan, an expansion of Medicaid under the ACA that covers more than 800,000 low-income adults in Michigan.

Here are the key ACA provisions and programs she mentions, all or most of which could be affected by an overturning of the law:

  • Protection for people with pre-existing health conditions: Before the ACA became law, health insurance companies could deny coverage to people with certain health conditions, or charge them higher rates for coverage, which often made it unaffordable. Although this did not apply to people with job-related insurance, whose right to be covered at equal rates is protected under another law, the ACA’s provision means many people with health conditions can buy affordable insurance individually, including if they leave or lose their job. Tipirneni says about 150 million people could be affected by the loss of this provision.

  • Health insurance coverage programs: In addition to making it possible for states to expand Medicaid to more low-income adults, the ACA created a marketplace at healthcare.gov where individuals can buy their own coverage, and allows parents to cover their grown children on their insurance plan up to age 26. All of these programs, which together cover tens of millions of Americans, could end if the ACA is overturned. Loss of health insurance by many or all of these individuals could lead to worse health, according to many research studies done before and after the ACA became law.

  • Medicare drug costs: The ACA provided for the “doughnut hole” of drug costs for older Americans, and those with serious disabilities, to be closed. That hole was created by the previous health policy that created the Part D prescription drug benefit to address high drug costs previously paid by Medicare enrollees. Before the ACA closed the hole, people had to pay the remaining cost of their medications after Medicare paid for a certain amount, though coverage would resume after they reached a high amount of spending. An overturning of the ACA would mean higher drug costs for many Medicare participants.

  • Preventive health care costs: The ACA provides for all insured Americans to receive certain preventive services without having to pay out of pocket in the form of co-pays or other cost sharing. From vaccines to mammograms, this provision is designed to keep cost from being a barrier to Americans’ getting the kinds of care that have been proven to spot health problems earlier or prevent costly problems later. If the ACA is overturned, those up-front costs will return, and as U-M researchers have shown, health dollars won’t be spent as wisely.

  • Worsened health disparities: A general effect of the ACA, Tipirneni says, has been to reduce differences in health care and health outcomes among people of different racial and ethnic backgrounds, incomes and education levels. Although Americans from disadvantaged backgrounds still face many inequalities in health and care, as U-M researchers have shown, a reversal of the ACA could reverse the progress that has been made in recent years.   

In addition to the effects on individuals from the loss of these provisions and programs, an overturning of the ACA would also impact many other aspects of health care at the state and national level. 

To learn more about the potential effects of the case, watch this video of health policy experts from across the country discussing the ACA and its intersection with the pandemic, the election and the court case.




Filters close

Showing results

110 of 4573
Released: 15-Jan-2021 5:40 PM EST
Research Links Social Isolation to COVID-19 Protocol Resistance
Humboldt State University

As health officials continue to implore the public to wear masks and practice social distancing, recent research by Humboldt State University Psychology Professor Amber Gaffney provides key insights into connections between social isolation, conspiratorial thinking, and resistance to COVID-19 protocols.

Newswise: Rapid blood test identifies COVID-19 patients at high risk of severe disease
Released: 15-Jan-2021 5:35 PM EST
Rapid blood test identifies COVID-19 patients at high risk of severe disease
Washington University in St. Louis

Scientists at Washington University School of Medicine in St. Louis have shown that a relatively simple and rapid blood test can predict which patients with COVID-19 are at highest risk of severe complications or death. The blood test measures levels of mitochondrial DNA, which normally resides inside the energy factories of cells. Mitochondrial DNA spilling out of cells and into the bloodstream is a sign that a particular type of violent cell death is taking place in the body.

Released: 15-Jan-2021 2:55 PM EST
COVID-19 deaths really are different. But best practices for ICU care should still apply, studies suggest.
Michigan Medicine - University of Michigan

COVID-19 deaths are indeed different from other lung failure deaths, according to two recent studies, with 56% of COVID-19 patients dying primarily from the lung damage caused by the virus, compared with 22% of those whose lungs fail due to other causes. But, the researchers conclude, the kind of care needed to help sustain people through the worst cases of all forms of lung failure is highly similar, and just needs to be fine-tuned.

Released: 15-Jan-2021 2:50 PM EST
45% of adults over 65 lack online medical accounts that could help them sign up for COVID-19 vaccinations
Michigan Medicine - University of Michigan

As the vaccination of older adults against COVID-19 begins across the country, new poll data suggests that many of them don’t yet have access to the “patient portal” online systems that could make it much easier for them to schedule a vaccination appointment. In all, 45% of adults aged 65 to 80 had not set up an account with their health provider’s portal system.

Released: 15-Jan-2021 1:30 PM EST
New England Journal of Medicine publishes COVID-19 treatment trial results
University of Texas at San Antonio

A clinical trial involving COVID-19 patients hospitalized at UT Health San Antonio and University Health, among roughly 100 sites globally, found that a combination of the drugs baricitinib and remdesivir reduced time to recovery, according to results published Dec. 11 in the New England Journal of Medicine.

Released: 15-Jan-2021 12:40 PM EST
DNA test can quickly identify pneumonia in patients with severe COVID-19, aiding faster treatment
University of Cambridge

Researchers have developed a DNA test to quickly identify secondary infections in COVID-19 patients, who have double the risk of developing pneumonia while on ventilation than non-COVID-19 patients.

Released: 15-Jan-2021 12:30 PM EST
Fight CRC To Present Research Findings on The Impact of COVID-19 on the Colorectal Cancer Community at 2021 GI ASCO
Fight Colorectal Cancer

Fight Colorectal Cancer presents abstract at Gastrointestinal Cancer Symposium highlighting the need to address the barriers and opportunities for care within the colorectal cancer community during the COVID-19 pandemic

Released: 15-Jan-2021 12:25 PM EST
Technion to Award Honorary Doctorate to Pfizer CEO Dr. Albert Bourla
American Technion Society

Israel's Technion will award an honorary doctorate to Pfizer CEO and Chairman Dr. Albert Bourla, for leading the development of the novel vaccine against SARS-CoV-2, the virus that causes COVID-19. The honorary doctorate will be conferred at the Technion Board of Governors meeting in November 2021.

Released: 15-Jan-2021 11:30 AM EST
UW researchers develop tool to equitably distribute limited vaccines
University of Wisconsin-Madison

Researchers at the University of Wisconsin School of Medicine and Public Health and UW Health have developed a tool that incorporates a person’s age and socioeconomic status to prioritize vaccine distribution among people who otherwise share similar risks due to their jobs.


Showing results

110 of 4573

close
1.18073