JACKSONVILLE, Fla. – The Supreme Court is working to decide whether to leave in place the bulk of the Affordable Care Act, including protections for preexisting health conditions and subsidized insurance premiums.
On Tuesday, the justices took on the latest Republican challenge to the Obama-era health care law, with three appointees of President Donald Trump. At least one of those Trump appointees, Justice Brett Kavanaugh, seemed likely to vote to leave the bulk of the law intact.
“It does seem fairly clear that the proper remedy would be to sever the mandate provision and leave the rest of the act in place,” Kavanaugh said.
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In the court’s third major case over the 10-year-old law, popularly known as “Obamacare,” Republican attorneys general in 18 states and the administration want the entire law to be struck down. That would threaten coverage for more than 23 million people, as well as millions of others with preexisting conditions that now would include COVID-19.
According to AP VoteCast, which surveyed more than 3,600 voters in Florida:
- 50% believed the government should either repeal the law entirely or repeal parts of the law
- 50% suggested the government should leave the law as is, or expand it
Here’s a look at how that breaks down:
| Florida voters | Biden voters | Trump voters | |
|---|---|---|---|
| Repeal the law entirely | 23% | 4% | 96% |
| Repeal parts of the law | 27% | 20% | 77% |
| Leave the law as is | 13% | 81% | 18% |
| Expand the law | 37% | 84% | 15% |
But there is support for some sort of government-run health care option that people can choose to buy into. Of the voters surveyed, 71% either strongly or somewhat favor that while only 28% strongly or somewhat oppose.
Some people in Jacksonville, like Eddie Harold Lewis, said the program helped keep them alive.
“I had a colon operation. And they (the Affordable Care Act) helped me. If it wasn’t for that, I would be dead.” Lewis said.
“I don’t think you should get rid of it altogether,” said Larry Hubbard, a Jacksonville resident. “And I’m a Trump fan, but I still don’t think you should get rid of it altogether, but I think it could be improved.”
News4Jax spoke with people outside UF Health, the city-supported hospital that Jacksonville pays millions to each year to ensure health care is available to all.
Some patients at UF Health said they rely on the Affordable Care Act. Others said they are watching what could happen down the line.
One woman, who asked not to be named, said the Affordable Care Act really helps those on the poverty line.
“There are people that need insurance, that need help, that are not working. And that is their only option,” she said.
Rep. John Rutherford, R-Florida, has a different view. He wants a new health care program and says the current Affordable Care Act needs to go.
“I think we should come up with something better that does lower the cost for everyone, even those with preexisting conditions pay a community rate,” Rutherford said.
State Sen. Audrey Gibson, D-Florida, who has been an advocate for health care during her career, said these upcoming weeks will be important.
“I always tell people: Your health is your wealth,” Gibson said.
Dr. Carolyn McClanahan is from Jacksonville and has been involved in health care policy since the act was designed and instituted in 2015. She believes four things will happen:
- Nothing. The plan stays as-is.
- The individual mandate is removed, which would take away the requirement to buy insurance.
- The mandate and everything in the plan connected to it would be removed. That would include removing preexisting condition protections.
- The plan could be scrapped altogether.
McClanahan says getting rid of the ACA would put American with preexisting conditions in a rough spot.
“That means a lot to them,” McClanahan said. “If you have somebody with significant health issues, they’re going to treat them at free clinics.”
Last year after the enrollment period, there were nearly 2 million people signed up for the Affordable Care Act in Florida, according to healthinsurance.org.
President-elect Joe Biden was in the Obama Administration when the Affordable Care Act first came was created. He spoke publicly after Tuesday’s arguments.
“This argument will determine whether health care coverage of more than 20 million Americans who acquired it under the Affordable Care Act will be ripped away in the middle of the nation’s worst pandemic in a century,” Biden said in Delaware.
Questions from Barrett, who joined the court late last month following her nomination and confirmation to replace the late Justice Ruth Bader Ginsburg, did not point to a clear outcome. Trump’s other high-court appointee is Justice Neil Gorsuch.
The three Trump appointees have never ruled on the substance of the health care law. Barrett, though, has been critical of the court’s earlier major health care decisions sustaining the law, both written by Chief Justice John Roberts.
The current case stems from a change made by the Republican-controlled Congress in 2017 that reduced the penalty for not obtaining health insurance to zero. Without the penalty, the law’s mandate to have health insurance is unconstitutional, the GOP-led states argue.
The ruling is expected next spring.