On Tuesday, Texas will lead a group of 20 states in a legal challenge to the Affordable Care Act, the 2010 law that remade the U.S. health care system and has provided health insurance coverage for thousands of people in the Crossroads and millions in Texas.
Opinions about the ACA, also known as “Obamacare,” are still mixed, largely along party lines. Although overall opinions of the act tend to vary by political party, many of the law’s core tenets are popular with voters in both major parties, particularly the law’s protections for pre-existing conditions. Prior to the law, people with health conditions like diabetes, substance use disorder, and heart disease could be denied coverage or charged more if they tried to get health insurance outside of their jobs, according to the Kaiser Family Foundation.
But the law has remained controversial among Republicans, in part because of an ideological opposition to the federal government exerting additional control over the U.S. health care system. And although the law has allowed millions of Americans to be able to pay for their medical care, some people have seen their health costs increased as insurers raised their prices, particularly those people who earn too much money to qualify for tax credits to help pay their insurance costs.
Texas’ attorney general is leading this most recent challenge to the law. Oral arguments in the case are scheduled for Tuesday, and the Supreme Court is expected to issue a decision in the case sometime before next June.
The law has dramatically changed the U.S. health care system, and affects almost every American in some form, said Cynthia Cox, an ACA expert. Cox, who is also a vice president with the nonprofit Kaiser Family Foundation, said that if the law were to be completely thrown out, it would thrust the U.S. health care system into “chaos.”
Legal experts think it’s unlikely, although still possible, for the court to throw out the law in full. If the court opts to overturn the entire law, the health care system in the Crossroads and throughout all of Texas would change dramatically.
In Texas, one of the most significant changes brought about by the law was the creation of the individual insurance marketplace, said Jennifer Knoulton, the vice president of Regional Operations for Methodist Healthcare Ministries.
The marketplace offers a place where individuals can buy their own insurance plans if they aren’t able to get health insurance through their jobs, or through a public insurance program like Medicaid or Medicare.
“We know that most bankruptcies for individuals are caused by health care bills, and we know that having insurance and access to care is the way our health care system runs in this country,” Knoulton said. “So by having the ACA and providing the opportunity for people to select insurance and be covered be covered not only getting that preventive care that helps prevent some of those disease.
Last year, 1.12 million Texas enrolled for health insurance coverage through the marketplaces, Knoulton said.
“As the pandemic economy has demonstrated, people can lose job-based coverage at the drop of a hat,” Cox said during a public briefing on the Supreme Court challenge. “And before the ACA it was very difficult if not impossible for many people to maintain coverage if they lost their jobs.”
It’s unclear how many people in the Crossroads may have lost their health insurance when they lost work during the current recession.
Knoulton added that the law’s coverage of preventative care was particularly important in a region like South Texas, where diabetes is prevalent and where catching and treating the disease early is essential to prevent worse outcomes.
Jeannette Flores, an independent insurance agent in Victoria, said she’s worked with dozens of individuals and families in recent years who were able to pay for essential medical care, like chemotherapy, because of insurance they purchased on the marketplace. For customers who are self-employed, don’t get insurance through their job or don’t qualify for public insurance programs, marketplace plans are the only option to cover them in an emergency or if they get a serious medical diagnosis.