The U.S. Supreme Court in November will consider a case seeking to overturn the Affordable Care Act, which provides health insurance coverage to millions of Americans.
President Donald Trump’s nomination of Judge Amy Coney Barrett to fill Justice Ruth Bader Ginsburg’s seat has amplified the case, as Barrett could vote to repeal the law.
The Affordable Care Act (ACA) expands Medicaid coverage and prevents insurance companies from refusing coverage because an individual has a pre-existing health condition; it allows parents to keep children on their health insurance plans until they turn 26 years old; it prevents health plans from enacting annual or lifetime limits on the benefits someone receives; it expands eligibility for preventive care at no cost, and it contains an important legal provision that improves and expands health care for Indigenous people.
Without the ACA, those under 26 years old may lose their parents’ health coverage, pregnant women may have to pay for their well-baby visits, people with cancer may have to pay for mammograms, others may have to pay for vaccinations, and tribal members may lose access to life-saving resources and essential care services.
Repealing the ACA in November could be especially harmful, as many Americans would lose their health insurance coverage amid the COVID-19 pandemic.
But repealing the ACA, commonly known as “Obamacare,” could have local consequences as well.
Here’s how losing the law will affect Great Falls medical providers:
Benefis Health System
In his November 2020 report, CEO of Benefis Health System John Goodnow expressed his support for the ACA, and wrote, “our hope is obviously that the Supreme Court does not overturn the Affordable Care Act.”
Repealing the ACA would make it impossible for the hospital to “break-even” on Medicare reimbursement. Goodnow writes that because 75% of Benefis Health System patients are covered by governmental programs, Medicare reimbursements are “absolutely vital to Benefis Health System’s financial health.”
While Goodnow underscored the importance of the presidential election in determining national health policy, local elections are also critical for the future of the ACA.
After meeting with Benefis leaders and providers Sept. 29, Democratic candidate for Attorney General Raph Graybill said at a press event “health care in Great Falls is on the ballot in the Attorney General race.”
Graybill’s opponent, Austin Knudsen, said he entered the Attorney General race because not enough had been done to repeal the ACA.
If the lawsuit against the ACA succeeds, Graybill said “Great Falls could lose access to trauma care, specialized cancer treatment, and mental health services.”
Mark Groeller, compliance director at Alluvion Health, said losing the ACA would increase barriers to care for patients.
“A larger percent of our patient population would be uninsured. We have enjoyed the support of the federal and state legislature to expand insurance access, so that’s what would be at risk if the ACA was repealed,” he said.
Groeller added that repealing the ACA would likely limit Medicare and Medicaid support services available to Alluvion patients and that preventive care, including pre-screenings for disease and vaccinations, would be more costly.
“This was bipartisan legislation. It is comprehensive and includes a lot of protections that support Montanans,” he said.
Indian Family Health Clinic
Mary Lynne Billy, chief innovation officer of the Indian Family Health Clinic, said repealing the ACA would have dire consequences for Indigenous populations.
The Indian Family Health Clinic is a nonprofit clinic that provides health care to all federally recognized tribal members and descendants.
Often referred to as the backbone of Indigenous health care, the Indian Health Care Improvement Act (IHCIA) was passed in 1976 and is the “cornerstone legal authority for the provision of health care to American Indians and Alaska Natives,” according to www.medicaid.gov.
Billy said lawmakers and Indigenous people, including her father, fought for decades to secure the IHCIA. In 2010, IHCIA was permanently enacted under the ACA.
The IHCIA ensures American Indian providers have access to essential health care services and provides life-saving resources for patients in critical health emergencies, like covering cost of travel, among other essential provisions.
“Simply said, if the ACA goes away, we lose the Indian Health Care Improvement Act, and years and years of very important provisions that support American Indian people will be gone. It will set tribes back to the 1950s,” Billy said.
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