November’s election could yet again mean trouble for the Affordable Care Act

By: - April 14, 2022 7:49 am
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A Nevada Health Link table at an event to promote open enrollment in 2019. (Courtesy photo)

The Affordable Care Act, the health care bill signed into law 12 years ago as of March, has mostly survived the U.S. Supreme Court rulings and numerous congressional votes to repeal it, including a vote in 2017 when Republicans controlled Congress and the presidency. 

Recent comments from Republicans are raising questions about its fate if Democrats lose the Senate following the November midterm elections.

Republican Sen. Charles Grassley of Iowa recently said if his party retakes control of the Senate they will not try to repeal the Affordable Care Act. 

The Washington Post reported Wednesday that when asked by a constituent whether he’d repeal it and what the Republican plan is to provide affordable health care, Grassley responded “it’s not repealing the Affordable Care Act.”

“I’m saying that I would not – we’re not going to repeal the Affordable Care Act,” he said, according to the Post. He then clarified he was one of 50 Senate Republicans.

Will Pregman, the communications director for Battle Born Progress, offered a skeptical outlook on Grassley’s comments. 

“Nearly 1.2 million Nevadans have a pre-existing condition, and over 282,000 were at risk of losing their healthcare during the most recent attempt to repeal the law via the Republican-backed Texas v. US Supreme Court case,” Pregman said via email. “Republican Senators, including Grassley, repeatedly worked to repeal and sabotage the ACA during the last time they were in the majority. They’ve given us no reason to believe they wouldn’t do so again if given the chance.” 

Republican candidates running to unseat incumbent Nevada Democratic Sen. Catherine Cortez Masto have previously criticized the health care law, but they haven’t offered much detail on what alternatives they would seek if elected.

Adam Laxalt previously called the law the “most flawed piece of major legislation America has ever endured.” When running for governor in 2018, however, the then-attorney general said he supported its provisions protecting coverage for people with pre-existing conditions, as well as expanded Medicaid under the ACA..  

On his website, Sam Brown, the other Republican in the Senate primary, criticizes the Affordable Care Act, writing “politicians have allowed bureaucrats to write health care laws, like Obamacare, that flood the marketplace with regulations while driving up costs and lowering access to quality coverage.”

“We need leaders who understand that competition — not government — drives medical innovations that lead to better care and lower costs,” Brown’s website says.

Neither candidate responded to questions Wednesday about whether, if given the chance, they would repeal the law, and if so what they would replace it with. 

Even if the Affordable Care Act isn’t repealed, another problem awaits Nevadans.

The American Rescue Plan Act, federal relief legislation signed into law last March that directed $6.7 billion in funding to Nevada, expanded health care subsidies within the ACA. Officials estimated the subsidies resulted in a 25% increase in enrollment

People making more than 400% of the federal poverty level who were previously left to pay for insurance on their own became eligible for plans because of the subsidies, but those plans are set to expire at the end of 2022. 

A recent report from the Robert Wood Johnson Foundation and the Urban Institute estimated 23,000 people in Nevada would lose coverage if enhanced premium tax credits aren’t made permanent. 

The Build Back Better bill, legislation that would have made investments in climate policy and social spending but stalled in the Senate, included provisions to keep the expanded subsidies in place.  

In a statement, Chelsey Winiger, the Nevada state director for the health advocacy organization Protect Our Care, said “Nevadans are counting on  Congress to extend the American Rescue Plan’s premium tax credits.” 

“Thanks to the American Rescue Plan, enrollment in high-quality coverage is at an all-time high and families have more breathing room to pay for essentials like food and rent at a time when families are concerned about rising prices,” she said. “This new study underscores that the consequences of letting these tax credits expire would be devastating for millions of people.” 

The majority of congressional Democrats have also been pushed to take action on reining in prescription drug costs. The House passed a bill to cap the price of insulin at $35 for private insurance and Medicare, but it still faces opposition in the Senate. 

Grassley during a Senate Finance Committee in March acknowledged  the “difficulty of passing something like this in a Republican Congress,” adding, “If we want to reduce drug prices, then we need to do it now.”

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Michael Lyle
Michael Lyle

Michael Lyle (MJ to some) has been a journalist in Las Vegas for eight years.  He started his career at View Neighborhood News, the community edition of the Las Vegas Review-Journal. During his seven years with the R-J, he won several first place awards from the Nevada Press Association and was named its 2011 Journalist of Merit. He left the paper in 2017 and spent a year as a freelance journalist accumulating bylines anywhere from The Washington Post to Desert Companion. While he covers a range of topics from homelessness to the criminal justice system, he gravitates toward stories about race relations and LGBTQ issues. Born and mostly raised in Las Vegas, Lyle graduated from UNLV with a degree in Journalism and Media Studies. He is currently working on his master's in Communications through an online program at Syracuse University. In his spare time, Lyle cooks through Ina Garten recipes in hopes of one day becoming the successor to the Barefoot Contessa throne. When he isn’t cooking (or eating), he also enjoys reading, running and re-watching episodes of “Parks and Recreation.” He is also in the process of learning kickboxing.