U.S. Supreme Court Obamacare case is about healthcare, but it’s also simple math

Nine justices of the Supreme Court of the United States have in their hands the fate of health insurance for approximately 20 million Americans.

Tuesday morning marked oral argument in a Supreme Court case challenging the Affordable Care Act.

The Trump administration and 18 Republican-leaning states argue that the entire law should be gone. After federal lawmakers in 2017 reduced the individual mandate penalty for no health insurance to zero, the entire Affordable Care Act (ACA) must fall with that, they hold.

Now the question is which party can convince at least five members of the High Court that they have the best case, a question that has resonated again as the coronavirus pandemic continues to increase. More than 10.1 million Americans had contracted COVID-19 on Tuesday, according to a count from Johns Hopkins University.

There’s also Justice Amy Coney Barrett, a conservative-leaning judge who replaces Justice Ruth Bader Ginsburg, a member of the liberal wing of the court who died in September at the age of 87.

Then there’s the addition of President-elect Joe Biden, a health-care advocate who is set to take office in January as the court reflects on its ruling, which is expected to be released in the spring of 2021.

Biden, who was vice president when President Barack Obama signed the law in 2010, cannot prevent the court from deciding the case once he takes office, according to legal observers. But with leave of the court, his administration can turn around and argue that the law must be obeyed.

Biden was due to speak about the trial later Tuesday, according to his transition team.

Court ruling could determine access to health insurance for millions of people during pandemic

The Supreme Court’s ruling on the Affordable Care Act would have fairly immediate ramifications for many Americans who have lost their employer-sponsored insurance amid layoffs triggered by the coronavirus pandemic.

More than 6 million workers have lost access to health insurance provided by workers since the start of the pandemic, according to one estimate.

A recent report by the Institute for Economic Policy, a non-profit, non-partisan think tank, estimates that around 6.2 million workers have lost access to the health insurance they obtained from their employers due to their layoff since the start of the coronavirus pandemic. This figure takes into account workers who were initially laid off, but have since found new jobs.

In many cases, the health care plans of these workers also covered their spouses, partners and dependents. In total, rising unemployment has cost around 12 million people their health insurance coverage.

However, due to the expansion of health insurance options created by the Affordable Care Act, most of these workers are eligible for government-subsidized health insurance.

Open healthcare enrollment through the Affordable Care Act Marketplace runs until December 15.

“ Some people will be excluded from the scope of the ACA, particularly in January 2021 when [unemployment insurance] benefits cease for many and some adults fall into the Medicaid coverage gap due to states’ decision not to extend ACA coverage.

A separate study by the Kaiser Family Foundation found that nearly half of people who were uninsured after losing their jobs were eligible for Medicaid. And about a quarter of people who have lost their employer-sponsored plans could be eligible for subsidized insurance underwritten through insurance markets established by Obamacare.

“Some people will be excluded from the scope of ACA, particularly in January 2021 when [unemployment insurance] the benefits cease for many and some adults fall into the Medicaid coverage gap due to state decisions not to extend coverage under the ACA, ”the researchers wrote.

In all, millions of Americans had health insurance coverage that Obamacare made possible before the onset of the coronavirus pandemic.

And in January 2020, 70.7 million people were enrolled in Medicaid or the Children’s Health Insurance Program (CHIP), up from 14.2 million in 2013.

Another factor in the extension of Obamacare coverage that is of concern to many Americans in the COVID age as well is the requirement for insurers to provide coverage to people with pre-existing conditions.

This is because COVID-19 could be considered a pre-existing illness, especially for people with persistent symptoms.

Prior to the adoption of Obamacare, health insurers could deny coverage, limit payments, or charge higher premiums for people with pre-existing health conditions. If the Supreme Court removed the Affordable Care Act, these protections would likely disappear.

This subtraction could result in more expensive additions, according to some researchers. The pandemic may have already added about 3.4 million adults under the age of 65 who have contracted COVID-19 to the ranks of Americans with pre-existing illnesses, according to the Commonwealth Fund, a private foundation that offers scholarships and health analysis.

Before the pandemic began, the United States had as many as 133 million people with one or more pre-existing conditions, Commonwealth Fund researchers said.

(During the election campaign, Trump and Vice President Mike Pence said pre-existing conditions would be protected, but critics said Republican plans and protections were sparse.)

How will Judge Barrett affect the decision in the case?

Democrats have warned that Barrett’s appointment to court could spell the end of the Affordable Care Act. Barrett wrote in the past criticizing Chief Justice John Robert’s decision in the 2012 case, even going so far as to say that the bill should be called “SCOTUScare”.

But Republican lawmakers said Barrett’s position on the case was unknown. And Barrett said during his confirmation hearings that he made no promises to anyone in return for his appointment.

“I didn’t make any commitments or agreements or anything like that,” he said during the hearings. “I am not here on a mission to destroy the Affordable Care Act. I am here only to uphold the law and respect the rule of law.

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