ACA Repeal Lawsuit Would End Healthcare Coverage for 395,000 Marylanders

Photo by Kjetil Ree via Creative Commons

The Supreme Court is set to hear oral arguments today aimed at declaring the Affordable Care Act unconstitutional. If the lawsuit to repeal the Affordable Care Act is successful, nearly 395,000 Marylanders would lose their healthcare coverage, nearly doubling the proportion of Marylanders who are uninsured according to a new analysis from the Urban Institute. Despite the Covid-19 pandemic, the Trump Administration and 18 state Attorneys General are asking the Supreme Court to strike down the entire law. The repeal of the Affordable Care Act would throw the healthcare system into chaos in the middle of a pandemic and recession causing thousands of Marylanders to lose their coverage at a time when they need it the most and many more would pay more for coverage or care and lose protections for their pre-existing conditions.

The Affordable Care Act has been a lifeline during the pandemic, providing coverage for thousands of Marylanders who have lost their jobs or experienced sharp drops in income in the recession. If the Affordable Care Act is stuck down, an estimated 21 million people would lose coverage nationally by 2022, and the losses could be even larger in 2021 while the public health crisis is still ongoing, according to the new analysis. In Maryland, striking down the Affordable Care Act would leave 16 percent of people under age 65 without health insurance—an even higher share of our population than lacked insurance before the law’s passage.

The loss in coverage from striking down the Affordable Care Act would reverse the law’s historic progress in reducing racial health disparities in health care coverage and access to care that often stem from structural racism. While overturning the Affordable Care Act would increase uninsured rates dramatically for all racial and ethic groups, it would case nearly 1 in 10 non-elderly Black and Hispanic people nationwide and more then 1 in 10 American Indians and Alaska Natives to lose their health coverage and become uninsured. In Maryland, the share of people of color without health insurance fell by nearly half from 2010 to 2019, largely because of the Afordable Care Act, and the share of Black Marylanders without health insurance fell by two-thirds. These groups would be hit hardest by a decision to strike the law down.

But there would be some winners if the lawsuit succeeds. Wealthy people and certain corporations would receive billions in tax cuts, a Center on Budget and Policy Priorities analysis shows:

• The highest-income 0.1 percent (1 in 1,000) households would receive tax cuts averaging about $198,000 per year. This group has annual incomes over $3 million. A portion of these tax cuts would come at the expense of the Medicare Trust Fund, which would lose about $10 billion in revenue each year.
• Pharmaceutical companies would pay $2.8 billion less in taxes each year, even as millions of seniors could pay billions more for prescription drugs because eliminating the ACA could reopen the “donut hole” gap in Medicare’s prescription drug benefit.

The Affordable Care Act is working in Maryland and has had a significant positive impact for many individual Marylanders, as well as our economy. Hundreds of thousands of people gained health coverage, hospitals are seeing fewer emergency room patients without coverage, and businesses are spending less on employee insurance than they would have without the Affordable Care Act. The Affordable Care Act has bolstered Maryland’s ability to deal with both the pandemic and the resulting economic recession. Striking down the law would harm those who have suffered the most as a result of the public health crisis and economic fallout, while providing large tax cuts to the wealthy.