Fighting On for Affordable Health Care

For millions of Americans, from coast to coast, the Affordable Care Act (ACA) is more than just a law—it’s a lifesaver.

March 4, 2015: Hundreds of supporters of the Affordable Care Act rallied on the steps of the Supreme Court as the Court heard oral arguments in King v. Burwell. SEIU members, including registered nurses, front-line healthcare workers, consumers and other working women and men stood together in the rain—singing, chanting and cheering on behalf of the millions of people whose lives have been changed for the better by the ACA. ~ Washington, DC ~ Photo by David Sachs / SEIU
(David Sachs for the SEIU / Creative Commons)

President Trump’s Department of Justice is asking the courts to overturn the groundbreaking healthcare law. If the courts decide to, the results will be devastating: Twenty-one million Americans will lose their health insurance outright, and millions more will face discrimination for pre-existing conditions that either put their insurance costs out of reach or allow insurance companies to deny coverage for services they need most.

Since the ACA’s passage, the rates of uninsured people in the U.S. have plummeted to historic lows. In the last nine years, 20 million Americans have gained access to the care they need. Since 2010, 130 million people living with pre-existing conditions have also had the security of knowing they cannot be discriminated against or denied coverage due to a health condition.

At least 37 states and the District of Columbia have also expanded Medicaid under the ACA, which helps provide affordable health care for seniors, people with disabilities, low-income families, women and children. Voters in Utah, Idaho and Nebraska cast their ballots to join those ranks in 2018—bypassing conservative elected officials who long refused to fully implement the law and ensure their constituents could get health care.

The ACA is a success, and it becomes more popular every year—despite persistent attacks from partisan opponents. During the 2018 midterms, health care was the top issue for the majority of voters. Those voters sent a clear message: they want lawmakers in Congress to protect and build on the ACA, not continue wasteful efforts to repeal and dismantle the law piece by piece through executive action.

Unfortunately, President Trump and his allies—after insisting they support protections for pre-existing conditions and increased treatment for opioid addiction treatment—are renewing their war on healthcare. But Democrats in the House are leveraging the election mandate to expand and strengthen the ACA.

Speaker Nancy Pelosi, along with other House leaders, recently introduced legislation that will provide new tax credits and subsidies to help families better afford coverage from ACA marketplaces. The package of bills also shores up protections for people with pre-existing conditions against further attacks and remedies some of the damage President Trump has inflicted.

There are two directions that our country can go on health care in the coming years. The first forges ahead with lower costs, better quality coverage and universal coverage for everyone. The second would take us back to a time when insurance companies could charge more for pre-existing conditions, refuse to cover basic services and cap or limit coverage in order to inflate profits at the expense of our health.

Democrats don’t all agree on all the same policies, but they are united in the fight to push for more progress under the ACA toward universal coverage. President Trump, however, has made clear his intent to take us all backward. In addition to asking the courts to overturn the entire ACA, Trump’s proposed 2020 budget would repeal the law and cut over $1 trillion from Medicaid—which provides healthcare to over 70 million people, at much lower costs than private insurance, and has been fundamental in the fight against the opioid crisis. 

If Trump succeeds, no one would lose more than women. Women are more likely to be without health coverage than men and have benefited most from passage of the ACA and the expansion of Medicaid—the leading payer of family planning services and births that funds half of all births each year. Aging women, who tend to have fewer resources for retirement, are also more likely than men to depend on Medicaid for long-term care.  

Ending the ACA means returning to a time when being a woman was essentially synonymous with having a pre-existing condition. Insurance companies made the rules and routinely charged women significantly more for coverage simply because we’re women. Pregnancy was deemed a pre-existing condition even though more than 80 percent of women in the United States become mothers. Health insurance companies didn’t have to cover the cost of maternity care, let alone pay for birth control. 

Health care has very tangible and direct impacts on people’s lives, pocketbooks and families. Quality, reliable, affordable coverage opens up opportunity for millions of people who may want to pursue higher education, start a business, switch jobs, start a family or relocate. 

Instead of retreating from the progress we’ve made toward improving people’s lives, lawmakers from both parties should be working together toward bigger and more ambitious solutions to provide better health care for everyone.

In 2017, working families, older Americans and people with disabilities rose up across the country to resoundingly reject the GOP’s repeal of the ACA. In 2018, voters cast their ballots for health care advocates and kicked many repeal supporters out of office. As we prepare for the 2020 elections, this momentum will only continue to grow.  

We fought for decades to secure affordable health care. We’re ready to do everything it takes to protect and expand that victory.


Margarida Jorge is the executive director of Health Care for America Now, the national grassroots coalition that ran a $60 million five-and-a-half year campaign from 2008-2013 to pass, protect and promote the Affordable Care Act and protect Medicare and Medicaid. HCAN has come back together to fight the Republicans’ all-out effort to take away America’s health care and put people at the mercy of the health insurance companies again.