COVID-19 and the ACA’s 10th Anniversary

On March 23, 2020, we mark the 10th anniversary of the Affordable Care Act (ACA). Especially at this moment, we are grateful for the improvements in our health system that were sorely needed and now help at at time like this.

In the context of the COVID-19 crisis, California’s health system would be much less equipped to deal with the pandemic if the ACA had not been put in place. Prior to the implementation of the ACA:

  • we had four million more uninsured Californians, and a uninsured rate of nearly 20%;
  • we had more financially struggling hospitals and health providers, and we didn’t have the resulting surge in our health system capacity throughout the state;
  • we had those who are older or with pre-existing conditions (those most at risk for COVID-19) being denied for coverage;
  • we had hundreds of thousands of Californians in “junk” health plans that didn’t cover essential health benefits, and didn’t cover screening and testing for a virus like COVID-19; and
  • we had hundreds of thousands of people losing their jobs and their coverage and with no viable option for coverage

On this last point, we are relieved that many of those who will be losing income, employment and/or benefits now have a safety-net: Medi-Cal and Covered California. Medi-Cal is no longer just a lifeline for the long-term low-income family, but a safety-net for the rest of us. Before the ACA, an expensive COBRA plan might have been the only option for a worker to keep coverage, but now Covered California offers more choices and thanks to new state subsides enacted last year, is more affordable than ever for many.

Yet even in the middle of this public health emergency, the Trump Administration is still trying to undo the ACA, cut and cap Medicaid, and seek other counterproductive restrictions on care and coverage. To appropriately respond to this pandemic, the Trump Justice Department should withdraw from the lawsuit challenging the ACA immediately. They should drop the block grant and fiscal rules that seek to cap and cut Medicaid, as well as the work reporting requirements, public charge rules, and other regulatory efforts that which are not just counterproductive in this moment, but could risk lives by putting up roadblocks for many to get the testing and treatment they need.

The COVID-19 public health emergency has caused massive disruption in our society and economy. Hopefully it disrupts the politics of health care too. We cannot fight the equivalent of “war” against the “hidden enemy” of a coronavirus, without our policies going in the right direction.