For Immediate Release                                                                                                
June 24, 2020    

Media Contact:

Stacy Stanford | 801-718-6130

SALT LAKE CITY  –  Despite the COVID-19 pandemic and resulting major recession, the Trump Administration and 18 state attorneys general, including Utah’s Sean Reyes, are expected to file briefs this week asking the Supreme Court to strike down the entire Affordable Care Act (ACA). If the lawsuit succeeds, at least 102,000 Utahns – likely many more – would lose health coverage.

“The administration and AGs’ lawsuit has the potential to throw the health care system into chaos in the middle of a pandemic and economic recession,” said Stacy Stanford, Health Policy Analyst for Utah Health Policy Project. “Tens of thousands of Utahns would lose coverage and many more would face higher costs for coverage or care.”

The Supreme Court is likely to decide the case in the first half of 2021, when the unemployment rate is still expected to be about 10 percent and the public health crisis may still be ongoing. ACA repeal was projected to cause 20 million people to lose coverage nationally – and 102,000 people in Utah – before the crisis, but many more would likely lose coverage if the law is repealed during a deep recession, when even more people will turn to ACA programs for coverage.

Many of the estimated 162,000 Utahns who have already lost job-based health coverage during the recession are eligible for coverage thanks to the ACA. Estimates show 57% percent are eligible for Medicaid coverage – a large share through the ACA expansion – and another 28% percent are eligible for marketplace coverage with premium tax credits. In Utah,we have already seen a surge in Medicaid enrollment thanks to increases in need due to COVID-19 related unemployment and lost wages. Fortunately, Utah expanded Medicaid under the Affordable Care Act, a program many Utahns are relying on even more with the pandemic and economic recession. 

Both the Medicaid expansion and the premium tax credits that help moderate-income people afford private coverage in the health insurance marketplaces would be eliminated if the ACA is struck down.

Research shows the ACA has improved access to care, financial security, and health outcomes – with strong evidence that both Medicaid expansion and coverage through the ACA marketplaces save lives. Reversing these coverage gains would be expected to worsen all of these outcomes, and the adverse effects would be even greater with more people depending on the ACA for coverage during the recession.

The ACA also significantly narrowed racial disparities in health coverage, and the lawsuit would widen them. Based on pre-crisis estimates, repeal would cause nearly 1 in 10 non-elderly Black people, and 1 in 10 non-elderly Hispanic people, to lose their health insurance, compared to about 1 in 16 white people.

Coverage losses from the lawsuit would also lead to spikes in uncompensated care costs that would add to the financial burden on state and local budgets during an unprecedented state budget crisis and harm providers at a time when many will likely still be reeling from the large drop in their revenues due to the pandemic. Uncompensated care costs in Utah have fallen by 25% as a share of hospital budgets since the ACA’s major coverage provisions took effect. COVID-19 is threatening the survival of some community-based providers and safety net and rural hospitals.

Meanwhile, striking down the ACA would also eliminate other policies and protections important to addressing and recovering from the public health crisis. Utahns with pre-existing health conditions – which could include having had COVID-19 –could once again be denied coverage or charged higher premiums. Insurance companies would no longer have to cover preventive services, including vaccines, without cost sharing, and could go back to putting annual and lifetime limits on coverage. And Centers for Disease Control (CDC) funding would be cut.

“The ACA, including Utah's Medicaid expansion, has bolstered Utah’s ability to deal with both the pandemic and the resulting economic recession,” said Matt Slonaker, Executive Director of Utah Health Policy Project. “Striking down the law would impede efforts to end the public health crisis and deal with the fallout.”