It is ironic that the Affordable Care Act is celebrating its 10th birthday in the midst of the worst public health crisis of the century. Ten years ago, on March 23, 2010, President Obama signed the ACA into law. As incompetent and unprepared as our current administration seems to be in addressing the coronavirus crisis, we would be far worse off had Congress not adopted the ACA or had President Trump succeeded in repealing it in 2017.
Without the ACA, we would have 20 million more uninsured Americans. They would not be able to count on testing and treatment for coronavirus without going into debt. Many would simply have to forego care. A total of 135 million Americans with pre-existing conditions could face denial of coverage if they lost their jobs, as many are likely to do. Seventeen million American families would lack Medicaid coverage, which now provides access to testing and treatment. Twelve million seniors would still face higher prescription drug costs in the Medicare doughnut hole. Also, 2.3 million adult children who now have coverage until age 26 on their parents’ plans would lack that coverage. Three million fewer children would have Medicaid and CHIP coverage. Dozens more rural hospitals that have been kept open through expanded Medicaid coverage would have closed.
Nine million people would lack the premium tax credits that now help them buy coverage in the individual market. Insurers could still impose lifetime caps on coverage. Many insurers in the individual market would still refuse to cover prescription drugs, maternity services, and mental health and substance abuse treatment. Thousands of Americans would have died from lack of access to health care.
The ACA provided essential funding for the National Health Services Corps and for community health centers, which are playing a key role in fighting the coronavirus. It offered funding to increase the capacity of state and local public health laboratories. It assured coverage of preventive services by Medicare, Medicaid, and private insurers.
As bad as things are getting as coronavirus spreads, things could be so much worse if Congress had not adopted the ACA. We also need to be grateful to the Northam administration, the Democratic leadership in the General Assembly, and a few brave and insightful Republicans like Sen. Hanger who secured the adoption of the Medicaid expansion in 2018, ensuring nearly 400,000 Virginians access to health care they would otherwise have lacked. And we owe a debt of gratitude to Virginia Organizing, the Virginia Poverty Law Center, and other groups that have fought for expanding coverage.
If there is one lesson we should learn from the current pandemic, it is that if anyone lacks access to health care, we are all less safe. The ACA still faces major challenges — most importantly the Texas California lawsuit in which the Trump administration is arguing the Supreme Court should strip away the ACA and its protections for people with pre-existing conditions. But the last decade has seen dramatic improvements in coverage and care, which have made us all safer.
Timothy Stoltzfus Jost, emeritus professor, Washington and Lee University, lives in Rockingham.