Wayne Edgerly, age 63 from Washington County, went without health insurance for years. Now he is able to get care following a hip replacement surgery thanks to a plan that costs him $1.64 a month and has a $200 deductible. He also has peace of mind that he will not lose his home because of medical bills.
Wayne is not alone. Nearly nine out of 10 Mainers who got coverage through HealthCare.gov qualified for tax credits and have an average monthly premium of less than $100. Thanks to these tax credits, millions of Americans who only dreamed of being able to protect themselves and their families now have comprehensive coverage.
Unfortunately, the U.S. Supreme Court could change all of that. The court’s decision on King v. Burwell will determine whether these tax credits can continue to flow to consumers in states such as Maine or if affordable insurance will be out of reach for millions. Repealing this centerpiece of the law would have severe consequences for Maine people and our entire health care market. This is a make or break issue for our health care system.
The Affordable Care Act is working in Maine and across the country. Ten million Americans have gained coverage since the law’s implementation, and our national uninsured rate is at a record low. A decision to strip tax credits would be disastrous for millions. Studies estimate that anywhere from 8 million to 10 million Americans would lose health insurance. Everyone who buys their own insurance would be affected, with an estimated hike in premiums of 35 to 47 percent.
Thankfully, there is no legal basis for the Supreme Court to take health coverage away from millions of Americans. When Congress wrote and passed the ACA, everyone — Republicans, Democrats and the Congressional Budget Office alike — agreed the tax credits would be available for people living in all states.
The stakes could not be higher. The sudden elimination of a key component of the ACA could cause substantial disruptions to the U.S. health care system. Here in Maine, our health care system successfully adapted to the law for the past five years, which is why we, Maine’s insurance companies, health care providers and consumer and patient advocates, stand together in support of the ACA today.
According to the Urban Institute, 62,000 people in Maine would lose an average of $4,150 in tax credits and cost-sharing reductions if the court rules in favor of the plaintiffs; that’s a total of $257 million. An estimated 50,000 Mainers would become uninsured.
As fewer and fewer healthy people are able to afford coverage and enroll, insurance in the individual market will become more and more expensive. Eventually this process, known as a “death spiral,” will cause insurance markets in some states to collapse, leaving more people without access to affordable coverage. The resulting chaos would ripple through the health care system, impacting consumers and providers across the country. Nationally, health care spending by the 8.2 million uninsured would drop by 35 percent, resulting in a devastating decline in revenues for providers paired with a $12 billion-per-year surge in uncompensated care. All consumers of health care will bear these costs.
While this plays out in Washington, we will continue the important work to strengthen our health care system to serve the people of Maine. Some 74,792 Mainers recently renewed or enrolled in health coverage during the latest open enrollment period. And we cannot forget the ACA also has provided coverage to people with pre-existing conditions, allowed young people to stay on their parents’ plans and ensured preventive care is available without out-of-pocket costs.
Together we are making health insurance more accessible and affordable. We are confident the Supreme Court will do the right thing and recognize the ACA is deeply embedded in our health care system in a way that cannot and should not be unraveled. In the meantime, we will continue to work to ensure affordable, quality health care is available to Wayne and the millions like him who deserve coverage.
Emily Brostek is executive director of Consumers for Affordable Health Care. Kevin Lewis is CEO of Maine Community Health Options. Lisa Ryan, DO, is president of the Maine Medical Association. The Maine Primary Care Association has also signed on in support of this OpEd.