Here’s What Happens in Wisconsin If the Supreme Court Kills the Affordable Care Act

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By Jonathon Sadowski

September 23, 2020

US Supreme Court to rule on case to repeal Affordable Care Act one week after Nov. 3 election.

More than 224,000 Wisconsinites’ health insurance hangs in the balance while the US Supreme Court deliberates whether to end the Affordable Care Act following the death of Justice Ruth Bader Ginsburg, one of the most fervent supporters of the law on the Supreme Court.

Ginsburg died Friday, and Senate Republicans are poised to quickly confirm a successor to give President Donald Trump his third pick for a lifetime appointment on the nine-justice court.

A week after the Nov. 3 election, the Supreme Court will consider a Trump-backed, Texas-led lawsuit to kill the entirety of the Affordable Care Act. A sudden end to the ACA would result in 224,00 Wisconsinites and 23 million Americans losing health insurance amid the coronavirus pandemic, according to the Center for American Progress.

“Health care is on the ballot this election,” said Leslie Dach, a former Obama Administration health adviser and current chairman of Protect Our Care, a national group dedicated to defending the ACA. “And the recent death of Justice Ginsburg and the vacancy on the Supreme Court has dramatically heightened the danger.”

The confirmation of another Trump justice would boost the Supreme Court’s conservative majority to 6-3, all but ensuring the conservative majority would strike down the landmark Obama-era law. Chief Justice John Roberts, a George W. Bush-nominated justice, has sided with liberals to save the ACA before. His swing vote would not be enough to keep the law alive if no other conservatives break with the new majority.

Even if Trump’s new nominee is somehow not rammed through the confirmation process, the odds of the ACA surviving are looking slim. A tie vote—the likely outcome if Ginsburg’s seat is not filled—with Roberts siding with liberals would mean the case reverts back to lower courts, which already killed the ACA.

Polling has found majority support for the ACA itself, and popular support for many of its individual provisions such as mandating insurance companies cover people with pre-existing conditions, allowing children to stay on their parents’ insurance until they turn 26, and banning companies from instituting lifetime coverage limits.

In Wisconsin, over 2.4 million people have a pre-existing condition and 41,000 adults under 26 are on their parents’ insurance, according to Protect Our Care. All of those people would be at risk of losing health insurance without the Obama-era healthcare law. Further, 28,000 children in Wisconsin would lose coverage without the ACA, according to Protect Our Care.

“The stakes just couldn’t be higher,” said Sen. Tammy Baldwin (D-Wis.) during a Wednesday media call with other Senate Democrats.

Baldwin pointed out that Trump has a litmus test for judicial appointees: They must be anti-abortion and anti-ACA. A report released Wednesday by Baldwin and eight other Democratic senators called courts “the linchpin of the Republican anti-health care and anti-reproductive-rights agenda.”

Health care is the top voter issue nationally, and signs are already pointing to Ginsburg’s death firing voters up ahead of Nov. 3. 

Sixty-two percent of respondents to a national Reuters poll, including half of Republicans, said Ginsburg’s seat should be filled after the election; thirty percent of respondents said her death makes them more likely to vote for Democratic presidential nominee Joe Biden and 25 percent said they are now more likely to vote for Trump.

Likewise, 89 percent of Biden supporters and 85 percent of Trump supporters said the next Supreme Court pick was important or very important to them in a newly released national Marquette Law School poll.

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