The ACA is Critical to the Health of all Americans, Particularly as the Nation Struggles to Contain the Coronavirus

(Washington D.C. – June 29, 2020)

The Trump Administration’s efforts to dismantle the Affordable Care Act (ACA), including urging the Supreme Court to overturn the act, is ill-conceived and puts the health of millions of Americans at risk during the worst public health crisis in over a century.

While always a bad idea, overturning the ACA as COVID-19 infection rates hit new highs in five states, would be catastrophic and could result in excess deaths. The loss of the ACA would also exacerbate the racial inequities that exist in healthcare access, adding to the disproportionate deaths of Blacks and other people of color due to the pandemic.

The ACA has been the law of the land for over a decade and millions of people rely on it for essential health services.  If the act was overturned, more than 20 million Americans who gained access to healthcare through the ACA created marketplace and Medicaid expansion would lose that coverage, including vital protections related to pre-existing conditions. Plus, the nearly 30 million Americans who have lost their healthcare due to COVID-19 layoffs would lose access to the critical back-up source for health coverage provided by the ACA marketplace.

There are also major implications for public health. If the law is overturned, it would gut the nation’s investment in public health by eliminating over $15 billion over the next 10 years (FY2021-FY2030) for the Centers for Disease Control and Prevention (CDC) and other public health agencies. The Prevention and Public Health Fund, a dedicated funding stream created by the ACA and specifically designated for public health and prevention, funds approximately 11 percent of the CDC’s budget. These funds are put to work in every state to expand immunizations, prevent suicide, modernize laboratory and epidemiology services to detect and contain disease outbreaks, prevent childhood lead poisoning, and prevent diabetes and other chronic conditions.

Also at risk is the requirement that insurers cover recommended clinical preventive services without cost-sharing. These provisions have meant that an estimated additional 71 million Americans now have access to vaccines, tobacco cessation services, blood pressure and diabetes screenings and other life-saving services previously inaccessible to them.