Guest column: Health care in US could be on the brink of chaos for millions - pressherald.com

The future of health care in the U.S. will be debated in a lawsuit at the U.S. Supreme Court on Tuesday, Nov. 10. On that day, the Court is scheduled to hear arguments, both pro and con, on a lawsuit brought by many Republican Attorneys General and President Trump to eliminate the Affordable Care Act (known as Obamacare) in its entirety. They want the entire law thrown out. This law was passed in 2009 and enacted in 2014 to make health care more accessible to millions of Americans with no health insurance and to improve the way health care is provided.

The Court will not announce its decision on the day of the arguments. It will likely announce its decision in spring or early summer. For now, Obamacare is the law and will remain that way until or unless the Court decides otherwise. This means the national debate on the law will be hanging around for the rest of the campaign and well into the new administration. Understanding the consequences can assist in forming opinions and voting.

Access to health care for millions of Americans and programs to reduce health care costs will be eliminated if the Court overturns the ACA. There is no option to replace it. Chaos would exist. What would be next? Nobody knows. We are on the brink of the most major crisis and changes in health care in decades.

If the Court overturns ACA, every aspect would disappear including protection for pre-existing conditions, subsidies that help people purchase health insurance, Medicaid expansion for low income people, nutrition requirements for food labels, preventive services for Medicare beneficiaries, protection on the cap of expenditures, and health insurance for those up to age 26 on parents’ health plan.

According to the Economic Policy Institute, 29.8 million would lose insurance and 1.2 million jobs would be lost if Obamacare is repealed. In Maine, the number of people without insurance would jump by 122% to 95,000.The number of jobs lost would be 3,435.

What are the potential options for the Supreme Court Justices in deciding the lawsuit proposing complete elimination of health care for so many?. The Court could decide to overturn every aspect of the ACA and leave us hanging out there with no direction for health care. The consequences of this option are financial and

health care disaster for millions. It could overturn parts of the Act and not others, return the lawsuit to a lower court for correction or clarification or dismiss the lawsuit without comment. Some supporters of the lawsuit have proposed to retain coverage for pre-existing conditions but eliminate everything else. There are no plans om how to do this approach.

There have been legislative efforts to water down and repeal Obamacare in the past four years. Some have succeeded. However, efforts for total repeal have failed, largely due to the mobilization of voters. The force of voter mobilization can not be emphasized enough. The elections on November 3 could change the composition of key leaders and determine a new direction for health care.

Given the importance of health care to most Americans and the upcoming election, the time has arrived that voters in Maine should be informed how the two candidates for the U. S. Senate respond to the future of Obamcare. The candidates have a responsibility to inform the public what their beliefs are and how they would vote.

On the basis of documents in the public domain, Sara Gideon is opposed to ACA repeal and has published a comprehensive proposal to strengthen Obamacare. Susan Collins has not yet announced if she favors repeal of Obamacare or not, regardless of previous votes. She has stated she favors retention of pre-existing protection but not how it should be implemented. This is a problem since her position on total repeal is so ambiguous. We do not know how she would vote. Republican leaders favor repealt and have no plans to replace it.

The arguments before the Court on November 10 will not end the nation’s acute stress over the future of health care. Chaos, barriers and unparalleled uncertainty for most all Americans on how to obtain and pay for health care is likely to exist if ACA is reversed. The Court’s decision is clearly a key to future direction. Yet, this issue will be around for years — you can bet on it. Legislators will have enormous influence. Your vote holds the key.

Stephen F. Loebs is a retired professor emeritus of Health Policy and Management at The Ohio State University. He lives in Topsham.

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