The Case for ACA

The Affordable Care Act is set to appear in front of the Supreme Court on Tuesday, but any repeal of the act would change the lives of millions of Americans.


photo courtesy of Tom Mihalek-Reuters

Repealing the Affordable Care Act would force abounding numbers of Americans to choose between the absence of healthcare and financial ruin.

By Michelle Hwang, North Allegheny Senior High School

I write this article because I am afraid that tomorrow basic rights will be taken away from the American people. 

On November 10th, the Supreme Court will hear eight hours of oral debate over the Affordable Care Act (formally the Patient Protection and Affordable Care Act), at the end of which, the nine justices will decide whether or not a bill that extended health insurance to 20 million people deserves to live.

But before we dive into the nitty gritty, first is a little background knowledge. 

The Affordable Care Act, most commonly known as the ACA or Obamacare, is a set of health care reforms that aim to make health insurance more accessible and affordable, as well as to protect the people covered by it. Among other things, the ACA penalizes large employers who don’t provide health insurance to their employees, gives states the option to expand Medicaid programs, and perhaps most importantly, prevents insurance companies from denying coverage to people with preexisting conditions. 

This last measure come with its dangers. People with preexisting conditions, such as cancer, diabetes, or epilepsy, have a stronger desire for health care coverage, but they’re also likely to cost insurance companies more. The companies know this, so to account for these anticipated costs, they drive the premium prices up.

And because the Affordable Care Act aims to make health care coverage more affordable, this isn’t good. So, the legislation added the individual mandate.

The individual mandate requires that everyone, with a few exceptions, obtain some sort of health coverage or face a small penalty. The goal of the individual mandate is to keep premium prices low by flooding the healthcare market with people without preexisting conditions. This regulation is the most controversial part of the Affordable Care Act and is consequently the main topic of debate tomorrow.


In 2012, the individual mandate’s constitutionality was first challenged in the Supreme Court, but it was ultimately deemed constitutional as a part of Congress’ taxing power in NFIB v. Sebelius. However, in 2017, the Tax Cuts and Jobs Act (TCJA) set the penalty of the individual mandate to zero dollars, stripping the Affordable Care Act of its profit making abilities and reopening the dispute of its constitutionality. 

This brings us back to present day. Tomorrow, 20 states, led by Texas, will fight to repeal the individual mandate. They’ll claim that, without such mandate, the Affordable Care Act is useless as a whole and should be struck down, as well.

If the wrong choice is made, millions of people will be in danger of losing their right to affordable health care. 

The Republicans make the case that the ACA must be repealed with the individual mandate because the mandate is one of the main aspects of the law itself. Without the mandate, more and more healthy people will forgo buying healthcare coverage, and premiums will shoot up. 

The ACA is a law that has thoroughly embedded itself into today’s healthcare system and changed it for the better.”

However, when the mandate’s penalty was eliminated as part of the 2017 tax bill, this aspect of the ACA became nothing more than an baseless threat. Even so, census data revealed that health coverage remained rather steady, and premiums were still affordable. Although things became a little rocky, recent years ultimately prove that the Affordable Care Act is perfectly capable of functioning without its individual mandate. 

So, the ACA’s challengers have a flimsy argument for overturning the act, and they were expected to have an extremely difficult time pulling a Supreme Court majority in their favor. But with the passing of RBG and the confirmation of Amy Coney Barrett as her successor, the court’s dynamic has changed to a 6-3 Republican majority, making it a frightening possibility that portions of the ACA, or even the act in its entirety, will be repealed. 

Because of its close relation with the individual mandate, the part of the ACA at greatest risk of being overturned is the provision that protects citizens with pre-existing conditions. If this single legislation is removed, 133 million Americans with pre-existing conditions will be in danger of being left without health insurance. 

If the law is struck down in its entirety, the 21 million people who buy their insurance through health coverage marketplaces set up by the ACA or have qualified for Medicaid as a result of the act’s expansion of the program will be in danger of losing their health insurance. The three million children who received Medicaid when their parents applied for it will also lose their coverage.

Perhaps most relevant to high school students, overturning the ACA will erase the provision that allows children to stay under their parents’ health insurance until the age of 26. This means that two million young adults may be left without health care coverage, and that you and I might need to find a suitable and affordable health insurance provider the moment we turn 18.

Max Herman / Sipa via AP Photo

The ACA isn’t just some obscure law that only benefits a certain group of people who make a certain amount of money and meet certain qualifications. It is a law that has thoroughly embedded itself into today’s healthcare system and changed it for the better. It has created improvements that the vast majority of this country can see and feel.

This act recognizes that everyone should be able to receive the healthcare they need without facing financial ruin, and it recognizes that this right should be extended to all people regardless of their income or pre-existing conditions.

Overturning the ACA will cause enormous harm to many people. For the sake of most Americans, the Supreme Court must rule to keep the Affordable Care Act.

This story was originally published on The Uproar on November 9, 2020.