Skip to Content
MarketWatch

After Supreme Court upholds Affordable Care Act, here's how many people would have lost Obamacare

By Andrew Keshner

The high-stakes court decision ended in a 7-2 vote

The Supreme Court this week upheld the Affordable Care Act (link) in a vote of 7 judges to two judges.

The now-rejected legal challenge from Texas and 17 other Republican-leaning states said the entire Obama-era statute had to fall (link) because the mandate to take out insurance or pay a fee was unconstitutional. In 2017, Congress reduced the mandate's fee for people without insurance to $0. Obamacare also survived two previous Supreme Court decisions in 2012 and 2015.

So what was at stake? Approximately 31 million Americans can now exhale after Thursday's decision. That's the number of people who have coverage in some form or fashion under the 2010 Affordable Care Act, known as Obamacare, according to the U.S. Department of Health and Human Services.

The Urban Institute, an economic- and social-policy research organization in Washington, D.C., estimated that overturning the ACA would have left 21.1 million people uninsured, a 69% increase nationally. Those estimates are based on a projection of coverage and spending in 2022 that anticipates partial economic recovery from COVID-19.

Those people at risk of losing Obamacare would be located in the states where the health-care coverage was most widely adopted per capita. They include Maine, Kentucky, West Virginia, Montana, Michigan, and Pennsylvania. "Overall, un-insurance in the 37 states that expanded Medicaid eligibility under the ACA (including D.C.) will more than double," the Urban Institute said in a recent report. (link)

On Thursday, in California v. Texas, No. 19-840 (link), the Supreme Court's majority said the states didn't have standing (link)to question the ACA's validity. Separately, a group of attorneys general, led by the California attorney general, said that Obamacare was working effectively, given that the penalty was reduced to zero and, as such, they also argued that the "individual mandate" is separate from the workings of the law.

Significant changes

When enacted in 2010, the Affordable Care Act made several significant changes to the health insurance industry. It created new marketplaces for qualified health plans, it offered tax credits as subsidies for income-eligible people using those marketplace plans. It expanded Medicaid eligibility and also barred insurers from using pre-existing condition exclusions.

As of February, there were 11.3 million people enrolled in the marketplace plans, according to the Department of Health and Human Services (link). Approximately 1 million people are also enrolled in the ACA's Basic Health Program for income-eligible consumers. It also includes 14.8 million people with coverage via broadened Medicaid eligibility and around 4 million people who were already eligible for Medicaid, but gained coverage through outreach.

The Biden administration opened a special sign-up window through Aug. 15 to give people the chance to get coverage as the pandemic continued. More than 528,000 people signed up by April, according to the Associated Press. (link)

In the lead up to Thursday's ruling, Democratic-leaning states fighting to keep the law intact emphasized the stakes if the high court ripped up the entire statute. "States, health insurers, and millions of Americans rely on those provisions when making important -- indeed, life-changing -- decisions," those states, including California and New York, said in court papers.

Organizations filing briefs in support the law also emphasized the human aspect of the courtroom drama. For example, an amicus brief filed last year by groups like AARP, Justice in Aging and the Center for Medicare Advocacy said, "Health insurance is an essential part of people's lives, especially for those who have chronic illnesses. As a result, they cannot make informed life decisions while the legal viability of the ACA hangs in the balance."

-Andrew Keshner; 415-439-6400; AskNewswires@dowjones.com

 

(END) Dow Jones Newswires

06-19-21 1013ET

Copyright (c) 2021 Dow Jones & Company, Inc.

Transparency is how we protect the integrity of our work and keep empowering investors to achieve their goals and dreams. And we have unwavering standards for how we keep that integrity intact, from our research and data to our policies on content and your personal data.

We’d like to share more about how we work and what drives our day-to-day business.

We sell different types of products and services to both investment professionals and individual investors. These products and services are usually sold through license agreements or subscriptions. Our investment management business generates asset-based fees, which are calculated as a percentage of assets under management. We also sell both admissions and sponsorship packages for our investment conferences and advertising on our websites and newsletters.

How we use your information depends on the product and service that you use and your relationship with us. We may use it to:

  • Verify your identity, personalize the content you receive, or create and administer your account.
  • Provide specific products and services to you, such as portfolio management or data aggregation.
  • Develop and improve features of our offerings.
  • Gear advertisements and other marketing efforts towards your interests.

To learn more about how we handle and protect your data, visit our privacy center.

Maintaining independence and editorial freedom is essential to our mission of empowering investor success. We provide a platform for our authors to report on investments fairly, accurately, and from the investor’s point of view. We also respect individual opinions––they represent the unvarnished thinking of our people and exacting analysis of our research processes. Our authors can publish views that we may or may not agree with, but they show their work, distinguish facts from opinions, and make sure their analysis is clear and in no way misleading or deceptive.

To further protect the integrity of our editorial content, we keep a strict separation between our sales teams and authors to remove any pressure or influence on our analyses and research.

Read our editorial policy to learn more about our process.