WASHINGTON — Today, U.S. Senator Chris Coons (D-Del.), a member of the Senate Judiciary Committee, discussed the impact of the Affordable Care Act (ACA) potentially being struck down in the Supreme Court in his opening remarks at the confirmation hearings for Judge Amy Coney Barrett. Senator Coons highlighted the story of Carrie from Middletown, Delaware, a constituent who depends on the protections of the ACA. 

“Listen to the voice of Carrie who’s behind me to my right. Carrie from Middletown, Delaware used to pay $800 a month for ‘junk insurance’ as she called it – coverage so skimpy, she had to live in fear of going to the doctor’s office or needing medication. Because of the ACA, she was able to get better coverage to pay what she can afford based on her income,” said Senator Coons. “She has diabetes, she has high blood pressure, but thanks to the ACA, she can’t be denied care or coverage. She told me when we spoke, ‘This takes the stress and the worry out of it,’ and then asked me: ‘How is this even at issue? Wasn’t that settled years ago?’”

“Carrie’s right. She should have the peace of mind that you can care for yourself and your family if you get sick,” Senator Coons concluded.

On November 10, oral arguments will be presented before the Supreme Court in California v. Texas, a case which could result in the ACA being struck down. Tomorrow, Senator Coons will highlight the devastating effects of the Supreme Court overturning the ACA in the midst of a global pandemic. Overturning the ACA would rip health coverage away from 20 million Americans and eliminate protections for the 130 million Americans with pre-existing conditions.

In Delaware, if the U.S. Supreme Court overturns the ACA, it would mean:

Discrimination against those with pre-existing conditions—including COVID-19 survivors.

  • The 393,200 Delawareans with pre-existing conditions could face higher costs, fewer benefits, and could have trouble finding coverage.
  • Individual market insurers could deny coverage altogether for the 160,000 Delawareans who have pre-existing conditions that are considered “uninsurable.”
  • The 21,363 Delawareans who have been diagnosed with COVID-19 so far could face higher premiums and more meager coverage that puts health care out of reach.

Women pay more but get less.

  • Insurers could charge women higher premiums than men (i.e., “gender rate”) and offer fewer benefits for the 17,400 Delaware women under 65 covered through individual market plans.
  • Together, gender rating, reduced benefits, and the ability of insurers to deny coverage altogether could increase costs, bar access to care, and put coverage out of reach for 197,000 women under 65 and girls in Delaware with pre-existing conditions.
  • Insurers would no longer be required to cover essential health benefits—making it harder for the 199,200 Delaware women covered by private insurance in the individual and group markets to find coverage for maternity care, contraception, and cost-free screenings for breast cancer, cervical cancer, and bone density.

Higher costs for older Delawareans

  • Before the ACA, Delaware had no rating restrictions. Insurers could charge an “age tax” to small businesses or people buying coverage on their own.
  • If the ACA were overturned, insurers could again raise premiums or deny coverage or benefits for the 7,377 enrollees in Delaware’s marketplace between the ages of 55-64 and the thousands more purchasing coverage off marketplace and in the small group market.
  • Striking down the ACA would re-open the Medicare prescription drug “donut hole”—exposing 23,485 seniors to potentially thousands of dollars in out of pocket costs.

More Delawareans losing coverage during a global pandemic

  • 62,500 Delawareans enrolled through the Medicaid expansion could lose coverage.
  • Without Medicaid expansion and tax subsidies to help purchase Marketplace plans, even more Delawareans who have lost their job-based coverage could stay uninsured.

Judge Barrett’s record: 

Judge Amy Coney Barrett has already indicated she would vote to strike down the Affordable Care Act. Barrett has said she and Justice Antonin Scalia have the same judicial philosophy. Justice Scalia twice voted to overturn the Affordable Care Act. He wrote the dissenting opinions in NFIB v. Sebelius and King v. Burwell. 

Barrett criticized Chief Justice John Roberts for upholding the law, saying in 2017: “[Chief Justice John] Roberts pushed the Affordable Care Act beyond its plausible meaning to save the statute.” Barrett also expressed disagreement with the Supreme Court’s majority opinion in King v. Burwell, where the court upheld a key component of the law, saying the dissent had “the better of the legal argument.”

Full audio and video available here. A transcript is provided below.

“Today, because of the Affordable Care Act, insurance companies cannot discriminate against women for being women. They cannot charge more. They cannot treat pregnancy as a pre-existing condition. I cannot think of a sharper irony as we consider the legacy of Justice Ginsburg who dedicated her life to fighting for gender equality.

“It also prevents insurance companies from charging any with pre-existing conditions more, so Americans no longer have to worry about going bankrupt because of an unexpected illness or accident.

“Don’t take my word for it. Listen to the voice of Carrie who’s behind me to my right. Carrie from Middletown, Delaware used to pay $800 a month for ‘junk insurance’ as she called it – coverage so skimpy, she had to live in fear of going to the doctor’s office or needing medication. Because of the ACA, she was able to get better coverage to pay what she can afford based on her income. She has diabetes, she has high blood pressure, but thanks to the ACA, she can’t be denied care or coverage. She told me when we spoke, ‘This takes the stress and the worry out of it,’ and then asked me: ‘How is this even at issue? Wasn’t that settled years ago?’

“Carrie’s right. She should have the peace of mind that you can care for yourself and your family if you get sick.

“I’ve heard so many more stories from Delaware. Just over my shoulder here is Debbie from New Castle, a self-employed small business owner who receives her health insurance through the marketplace.  Her pre-existing condition requires her to attend physical therapy and doctors’ appointments multiple times each month.  Without the ACA, insurance companies would have charged her more because of her condition, and she would not be able to afford her medical bills and support her small business.

“There’s Barb Slater from Newark, Delaware who was diagnosed with Scleroderma four years ago. After losing her employer-sponsored health insurance, she was able to find new coverage in the marketplace thanks to the Affordable Care Act. 

“My inbox and the inbox of all my colleagues are filled with stories like Carrie’s, Debbie’s, Barb’s and they highlight the breadth of what the ACA means to the American people: the ability of young people to stay on their family’s insurance, lower out-of-pocket costs for seniors’ prescriptions, the elimination of lifetime caps. These protections are on the line – on the docket of the Supreme Court.”

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