ACA repeal more dangerous than ever for Floridians during pandemic and economic crisis
TALLAHASSEE, Fla. - Despite the COVID-19 pandemic and resulting major recession, the Trump Administration and 18 state attorneys general, including Florida’s Ashley Moody, are filing briefs today asking the Supreme Court to strike down the entire Affordable Care Act (ACA). If the lawsuit succeeds, at least 1.56 million Floridians — likely many more — would lose health coverage.
Last month, Florida Policy Institute (FPI) joined more than 100 organizations across the nation — including health care advocates, insurers, providers, worker representatives, and nonprofits — in urging the 18 states and Department of Justice to drop the lawsuit.
“Even in the middle of a global pandemic, the Administration and attorneys general are pursuing an action that would risk the health and lives of millions of Americans,” said Sadaf Knight, CEO of FPI. “We strongly urge Florida Attorney General Ashley Moody to withdraw from the lawsuit. More than one-and-a-half million Floridians would lose coverage and many others would pay more for coverage or care.”
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. ACA repeal was projected to cause 20 million people to lose coverage nationally —including more than 1.56 million in Florida — before the crisis, but many more would likely lose coverage if the law is repealed during a deep recession, when even more people will turn to ACA programs for coverage.
Many of the estimated Floridians who have already lost job-based health coverage during the recession are eligible for coverage thanks to the ACA. Estimates show 59 percent are eligible for marketplace coverage with premium tax credits. Florida has already seen a surge in Medicaid applications and enrollment.
Research shows the ACA has improved access to care, financial security, and health outcomes – with strong evidence that both Medicaid expansion and coverage through the ACA marketplaces save lives. Reversing these coverage gains would be expected to worsen all of these outcomes, and 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 its repeal 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 and 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 in Florida have fallen by 24 percent as a share of hospital budgets since the ACA’s major coverage provisions took effect. COVID-19 is threatening the survival of some community-based providers and safety net and rural hospitals.
Meanwhile, striking down the ACA would also eliminate other policies and protections important to addressing and recovering from the public health crisis. Floridians with pre-existing health conditions, which could include having had COVID-19, could once again be denied coverage or charged higher premiums. 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. And Centers for Disease Control (CDC) funding would be cut.
“The ACA has substantially reduced Florida’s rate of uninsured residents and it’s crucial in helping individuals deal with both the pandemic and the resulting recession,” added Knight. “Repealing the ACA would be disastrous for public health and impede our nation’s economic recovery.”
FPI is an independent, nonpartisan and nonprofit organization dedicated to advancing state policies and budgets that improve the economic mobility and quality of life for all Floridians.