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U.S. Supreme Court Takes Up Future of Affordable Care Act

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Monday, November 9, 2020   

FRANKFORT, Ky. -- Tomorrow, the Supreme Court hears oral arguments in cases that could decide the fate of the Affordable Care Act. Health coverage for more than a half-million Kentuckians is at stake, as well as millions of dollars in rural hospital revenue.

More than a dozen states are asking the court to repeal the 2010 law that overhauled the private health insurance market and expanded Medicaid. Dustin Pugel, senior analyst at the Kentucky Center for Economic Policy, said before the ACA, Kentucky's uninsured rate was in the double digits. But Medicaid expansion opened coverage to hundreds of thousands - many for the first time.

"And they were able to get care for chronic conditions," Pugel said. "There was a lot of tobacco cessation counseling; there were cancer screenings. People were able to get old injuries looked at for the first time. And a lot of research showed that it saved lives."

ACA opponents believe the "individual mandate" - requiring people to have health insurance - is unconstitutional. They argue because a previous court struck down the mandate, the entire law should be repealed. The Supreme Court is expected to make its decision by next summer.

In addition to allowing coverage for people with pre-existing conditions, Pugel said the ACA has had positive ripple effects on local economies.

"[Between] 45,000 and 50,000 jobs could be lost just by pulling that $3 billion in federal dollars out of our economy - some of those in healthcare, but also in other industries, like finance and construction," he said.

Pugel said eliminating the ACA would be especially problematic during the pandemic, when many people are getting sick or may have coronavirus complications that require long-term care.

"Having less uncompensated care because a lot of your patients are covered by Medicaid, definitely helped keep their doors open, and you know, could be the tipping point in a hospital's decision on whether or not to stay open," he said.

A 2019 University of Kentucky study found the number of Kentuckians who received colon cancer screenings after Medicaid expansion jumped by 230%, compared to before the ACA.


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