Protections for people with pre-existing conditions would vanish
. Initiatives to improve hospital quality would stop. Rules for calorie counts at restaurants would no longer be in force.Those are just some of the likely consequences if the federal courts rule in favor of a lawsuit challenging the Affordable Care Act and decide — as President Donald Trump said he hopes they will — that the entire law has to come off the books.
The Effects Would Touch Every Kind Of InsuranceThe most obvious and understood changes would affect protections for pre-existing conditions, which Trump keeps insisting he and Republicans are committed to preserving. And it’s not as if those 12.6 million would have coverage equivalent to what’s available on HealthCare.gov today. The plans would be cheaper, but only because they had big benefit gaps and weren’t even available to people with pre-existing conditions. Some people would save money, sure — mostly those who are healthy and able to stay that way.
In some states, cuts would happen automatically because the executive actions or laws authorizing expansion call for restoring the old, pre-expansion eligibility standards if the extra federal funds stop flowing. Taking all of this into account, enrollment in Medicaid would drop from 68.6 million to 53.2 million, by the Urban Institute’s reckoning.
The Affordable Care Act bolstered Medicare in several ways, most obviously by gradually eliminating a gap in prescription drug coverage, known as the doughnut hole, that left seniors on the hook for especially high out-of-pocket costs. Without the Affordable Care Act in place, the doughnut hole would open back up.
It’s almost like you’d need a special master to go through these changes, line by line, to figure out what’s constitutional and what’s not. Sabrina Corlette, research professor, Georgetown University But these experiments, some of which the Trump administration endorsed, were carried out through the Center for Medicare and Medicaid Innovation, which the Affordable Care Act authorizes and finances. Shutting down the law would mean shutting down the center and its programs, with unknown consequences for the health care providers participating in them.
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