Dr. Leana S. Wen is an emergency physician and a visiting professor at George Washington University Milken Institute School of Public Health. Previously, she served as Baltimore’s health commissioner. Follow her on Twitter: @DrLeanaWen. View more opinion articles on CNN.
(CNN)What is the worst time to overturn a law that provides healthcare for the uninsured? Surely, topping any list of answers would be: in the midst of the pandemic that is quickly becoming the leading cause of death in America.
Yet, the Trump administration is pushing forward with their position to invalidate the Affordable Care Act (ACA), with the Supreme Court due to hear the case in the fall
Even after Attorney General William Barr pushed the administration to adjust its position in the dispute over Obamacare set to be heard before the Supreme Court this fall, President Donald Trump reiterated Wednesday that his administration will continue its legal push to invalidate the ACA.
Trump told reporters: “We want to terminate health care for– under Obamacare because it’s bad, and we’re replacing it with a great health care at far less money and it includes preexisting conditions.” All the while, his administration has not yet put forward an alternative to the ACA.
A CNN article reported that Barr had argued for the administration to modify its legal stance in a lawsuit brought by a group of Republican states, in order to preserve parts of the law. Trump’s Wednesday comments, though he said he “didn’t know about that suggestion,” seemed to indicate that his administration would stick with its previous position, which seeks to invalidate the whole ACA.
This position could, depending on the outcome of the suit, impact 20 million Americans, according to the Urban Institute. With more than 30 million people who have already filed for unemployment benefits, many more millions will be expected to rely on the ACA for health care coverage in the coming months.
Without health insurance for as many Americans as possible, it will be difficult to contain the pandemic.
The novel coronavirus, Covid-19, is one of the most contagious diseases in the world. Key to controlling its spread is early diagnosis with widespread, accessible and free testing, followed by aggressive contact tracing and quarantining of contacts.
Although the federal government has passed legislation designed to cover costs for coronavirus testing and treatment for the uninsured, there are numerous loopholes that may still result in patients bearing the brunt of medical bills. The fear of financial jeopardy could deter infected people from seeking care, which would make efforts to managing Covid-19 even more challenging.
Health care for all other conditions also continues to occur during a pandemic. There is already concern that patients are not tending to their chronic conditions and heart attacks, strokes and other life-threatening issues are missed because patients do not want to have exposure to Covid-19.
Taking away health insurance would further exacerbate existing health problems, which would not only worsen health outcomes but also increase the overall cost to the health system if people wait until they are critically ill before seeking care.
In addition to the potential loss of health insurance for the more than 20 million who currently depend on ACA, the loss of the ACA could also result in having Covid-19 itself labeling the millions being infected as being uninsurable.
Patients with severe effects of Covid-19 could end up with lasting conditions including chronic lung and kidney conditions and even strokes and heart damage. Without the ACA’s protection for people with preexisting conditions, patients who have recovered from Covid-19 could be denied health care coverage.
Finally, among the groups most helped by the ACA are minorities and small business owners. These are the same individuals who are disproportionately affected by Covid-19. Removing ACA protections will worsen existing health disparities, which are already laid bare by the pandemic.
To be sure, the Covid-19 pandemic has revealed many problems with the health care system. The pandemic can be a clarion call to reenvision the entire way we deliver care. There are faults with the ACA that even proponents would say need improvement.
There will be time for reforms, but now is not the moment for overturning the entire system — not at the height of the outbreak, when thousands are dying every day.