What will a Supreme Court ruling against the Affordable Care Act mean for health care? The answer, actually, is pretty simple: veterans, seniors, people with pre-existing conditions, primary care doctors, people who buy coverage from the individual insurance market, children and adults with pre-existing conditions, and of course the uninsured, are among the tens of millions of Americans will lose out if the ACA goes away.
For the past several weeks, I have been tweeting (under the hash tag #WhatWeLOSEifObamacareGoes) about who will lose out, and what they will lose, if the ACA is overturned. Here is a partial list, drawn from credible studies and news reports:
More than ONE Million veterans will go without health insurance.
11 MILLION people who buy coverage in the individual insurance market will end up with reduced benefits.
Primary care doctors collectively will lose TENS of BILLIONS in higher Medicaid and Medicare payments.
62,000 THOUSAND "uninsurable" people with pre-existing conditions will lose access to coverage.
40 MILLION seniors on Medicare will spend an average of $20,000 more out of their own pockets for medical care and prescriptions.
The 47% of us who do not get needed screening tests and wellness examinations will face new barriers because insurers no longer will be required to cover preventive services at no cost to the patient.
Many more of us will end up having to get care from over-crowded emergency rooms.
And, of course, 32 MILLION uninsured persons—many of them from the working poor—will lose access to affordable health insurance coverage.
Elimination of the ACA will also have a negative impact on the economy in many states: California alone will lose 100,000 JOBS and 1.4 billion in ECONOMIC OUTPUT.
But I think the greatest thing we will lose is the chance to finally, after a century of trying and failing, do the right thing and ensure that all of us, no matter where we live or work or how much we earn or how healthy or unhealthy we are, will have access to affordable health insurance coverage. If the ACA goes away, I see no chance that Congress will enact a replacement plan to ensure coverage for all, at least not for another decade or so. And that will be to our lasting shame as a country.