Texas, Trump, and Health Care

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The Republican opposition to the Affordable Care Act is well known. The State of Texas sued the Obama Administration 48 times over the law. President Trump campaigned fiercely against it and has tried, unsuccessfully, to repeal it while in office.

It should come as no surprise then that on Monday the Trump Administration asked a federal court to invalidate the entire ACA. The Administration is wanting to rip up even the good, popular parts of the law – including the provision that prohibits insurance companies from denying Americans coverage for pre-existing conditions, like cancer, and Medicaid expansion efforts – without replacing it with anything.   

The impact would be significant. The more than 20 million Americans who received coverage under the ACA would be dropped from their coverage.

“It would be like invalidating the Interstate Highway System, causing chaos on an unimaginable scale,” a professor at Washington and Lee University School of Law told the Washington Post. “It’s conceivable that the entire Medicare payment system would collapse.”

For now, nothing changes; the ACA remains the law of the land. Observers believe the ACA ultimately will end up (again) at the U.S. Supreme Court.  

Ending the ACA would not help Texas’ health care crisis. The state, according to the Texas Medical Association, is the uninsured capital of the U.S.

A report from the Houston-based Episcopal Health Foundation and Urban Institute calculated about 22 percent of people under age 65 living in Harris County are uninsured, compared with 19 percent of all Texans. (Notably, 70% of the uninsured were in working families.)

“Uninsured people are far more likely than those with insurance to postpone health care or forgo it altogether,” notes the Kaiser Family Foundation. 

Last year, more than 1 million Texans enrolled in the ACA. Since its inception, Obamacare has helped reduce the state’s uninsured rate.

Democrats want to keep but improve the ACA, which is why health committees in the U.S. House yesterday introduced landmark legislation to lower health care costs and protect coverage for pre-existing conditions. The proposal would specifically increase financial assistance for those families who buy their own insurance.

With the Trump Administration’s renewed focus on health care – and Democrats know it’s a winning issue for them, as it was in 2018 – the 2020 election will likely be a final arbiter for the ACA.

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