When it was introduced nearly 10 years ago, the primary objective of the Patient Protection and Affordable Care Act (ACA) was to provide more Americans with affordable health coverage, and now strong evidence is emerging that suggests it may be saving lives and making some Americans healthier.
For example, as a result of state Medicaid expansion programs, patients with advanced kidney disease were more likely to be alive a year after starting dialysis. In Ohio, more than 25,000 people were able to quit smoking, while in Michigan, poor people with diabetes and asthma were admitted to hospitals less often after joining Medicaid.
These signs of improvement come at a time when the law’s future is uncertain. Eighteen Republican state attorneys general have filed a federal lawsuit that challenges the ACA on the grounds of unconstitutionality. Last year, a Texas trial court judge ruled that the entire legislation is invalid. A three-judge panel of the U.S. Court of Appeals for the 5th Circuit is set to issue an opinion on the case in the near future – putting the ACA before the Supreme Court for the third time. In addition, some of the 2020 Democratic presidential candidates are rejecting the ACA in favor of “Medicare for All” plans.
The Trump administration has not presented a replacement for the health benefits that cover millions of Americans under the ACA and plans to seek a stay if a federal court strikes down the law, possibly delaying a potential Supreme Court hearing until after the 2020 election.
“It’s difficult to come up with a solution everyone agrees with and is free market enough,” said Chris Meekins, a former Health and Human Services official under the Trump administration. “You know whatever you put forward is going to get slashed, so why put a plan that people can shoot arrows at out there?”