Your medical history can't prevent you from getting health insurance coverage in the United States. That should be a no-brainer. It is the case in every wealthy, industrialized nation and has been for decades. But in the U.S., it's only been a given for six years. The guaranteed issue protections in the Affordable Care Act (ACA) took effect on January 1, 2014, barring insurers from denying coverage to people on the basis of their health history, along with community ratings which hold premium costs down for people with preexisting conditions. Donald Trump is arguing right now before the Supreme Court that the entire law must be struck down. Senate Republicans are rushing to have Trump's Supreme Court nominee, Amy Coney Barrett, installed before the election. The court will hear the ACA case on Nov. 10.
So you bet your ass this election—and the fight to keep Barrett off the court—is about health care, and Joe Biden and team know that very well. Because at least 23 million Americans could immediately lose their coverage. That number is rising as more people are losing their jobs because of the COVID-19 pandemic and economic crisis, and are having to enroll in Medicaid. It also means that as many as 133 million people with medical histories that would have precluded them from having coverage in the pre-2014 days will now have to worry about it again. This is a handy reminder of what kinds of conditions could preclude you from getting an individual health plan. That's the status quo Trump and his nominee, Amy Coney Barrett, want to return to.
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There's no question of Barrett's hostility to the law. When the Supreme Court upheld the ACA in 2012, allowing states to refuse Medicaid expansion, Barrett wrote: “Chief Justice Roberts pushed the Affordable Care Act beyond its plausible meaning to save the statute,” and wrote that Justice Antonin Scalia’s view in dissent, “that the entire ACA should have been thrown out, was the correct approach according to the “statutory textualism to which most originalists subscribe.” In 2015, she praised the dissent in King v. Burwell, the previous absolutely ridiculous challenge to the law, saying it had “the better of the legal argument.” If she and the dissenters had had their way, the nonpartisan Urban Institute estimated that more than 8 million people would have lost health coverage and premiums would have gone up by 35% in 34 states. The sudden drop in healthcare spending would have sent the entire healthcare system into a chaotic nationwide meltdown.
There's also no question that this is a massively motivating issue for Democrats. We know that because we've been here before, just two years ago. "That was the issue that drove the 2018 campaign so substantially—it came right after a very, very clear threat," said Chris Jennings, a Democratic strategist on health care and a Biden campaign adviser in a New York Times interview. "This time, the fear of a takeaway was not as great. But now it's re-engaged and credible."
Biden is also on point. "President Trump sees a chance to fulfill his explicit mission: steal away the vital protections of the ACA from countless families that have come to rely on them for their health, their financial security, the lives of those they love," said Biden in a speech from Wilmington, Delaware, this weekend.
The campaign is also running the new television ad below, titled "Samantha," featuring Samantha McGovern and her child, Josephine, who has chronic lung disease. The whole McGovern family is recovering from coronavirus. "There is not a day that has gone by since this started that COVID does not terrify me," McGovern says in the ad. "Seven million people have gotten it—and three of them are in my home. My daughter has chronic lung disease, so that made all this very scary for us. What also scares me is Donald Trump trying to let insurance companies deny health coverage or charge more because of a preexisting condition. Trump is rushing through a Supreme Court nominee to do just that, strip away care from millions of Americans and end preexisting condition protections.”