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Health Insurance Coverage Gains in Jeopardy with Threat to ACA and COVID-19 Impact

October 07, 2020

Health insurance coverage gains earned over the last decade are in jeopardy as a result of the potential for the U.S. Supreme Court to overturn the Affordable Care Act (ACA) and the enormous impact of the COVID-19 pandemic.

Overturning the ACA could have dire consequences for millions of Pennsylvanians, U.S. Senator Bob Casey (D) and Governor Tom Wolf said yesterday during a virtual press conference.

Governor Wolf said that it is “imperative that we do everything in our power to protect the ACA and the millions of Pennsylvanians who have access to health care because of it, especially during a pandemic.” Casey said that, nationally, 23 million Americans could lose their insurance, and 135 million could lose protections for pre-existing conditions. Additionally, according to the Wolf Administration, coverage for nearly 6.5 million Pennsylvanians—including roughly 5.5 million with pre-existing conditions—could be threatened if the ACA is overturned.

A September 2020 report commissioned by HAP and conducted by Health Management Associates (HMA) found that COVID-19 has had serious implications for health insurance coverage in Pennsylvania, including:

  • The most significant financial impact of high unemployment is the loss of private insurance
  • People that have been laid off may lose employer health coverage, and those purchasing insurance on the individual exchange may no longer be able to afford the premiums
  • When people lose private insurance coverage, they may qualify for Medicaid
  • If those losing private insurance do not qualify for Medicaid, they will likely require uncompensated care

Those insurance dynamics will impact the financial stability of hospitals, and result in health consequences for our communities:

  • The economic impact of the pandemic will result in anticipated increases in uncompensated care, further jeopardizing an already difficult insurance climate
  • Community health may suffer due to unemployment, loss of insurance, and loss of housing stability

Kaiser Family Foundation (KFF) researchers continue to consider implications for the 15 million Americans enrolled in Medicaid expansion programs as of June 2019 (766,000 of whom live in Pennsylvania) and the additional people who enrolled since June 2019. During the height of the COVID-19 crisis alone—between February and June 2020—approximately four million Americans enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). According to KFF, if the ACA is overturned, most Medicaid expansion enrollees would become uninsured.

Additionally, a recent analysis found that nearly 1.5 million Pennsylvanians will become uninsured due to the COVID-19 pandemic. The resulting loss in coverage will shift millions across the country to seek coverage from the ACA and Medicaid.

HAP and the commonwealth’s hospital community have long supported access to comprehensive health insurance coverage for all Pennsylvanians and will continue to advocate for preserving the ACA’s core tenets and consumer protections and promote policies that mitigate the impacts of the COVID-19 global public health crisis.

For more information, contact Laura Stevens Kent, HAP’s senior vice president, strategic integration.