With impending ruling on Affordable Care Act, Washington governor, state health leaders ask for congressional support

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If the Fifth Circuit Court of Appeals and the U.S. Supreme Court uphold a lower court ruling that struck down the Affordable Care Act (ACA), the effects that would ripple across the country could be devastating, Washington state politicians warn.

In a letter to Washington's entire congressional delegation Tuesday, Gov. Jay Inslee, Washington State Insurance Commissioner Mike Kreidler and Washington Health Benefit Exchange CEO Pam MacEwan laid out what's at stake if the ACA is struck down.

Their concerns hang on an awaited decision from the Fifth Circuit in Texas v. Azar, in which the ACA was overturned entirely by the lower court. If upheld in the Court of Appeals, then at the Supreme Court, the impacts would be significant, the Washington state leaders write.

"There would be widespread and devastating implications for Washington state," the letter states. "We would lose billions of dollars in annual federal funding that directly finances affordable health coverage for working families in Washington — a cost so high it cannot realistically be assumed by the state — while depriving hundreds of thousands of our residents of health insurance, damaging our state’s economy and destabilizing our insurance markets."

Since the act was put in place, Washington's uninsured rate has dropped from 14 percent to 5.5 percent, with thousands in the state who newly got insurance being able to get treatment for cancer, mental health and substance use disorder, among many other things, the authors note.

But should the ACA (a.k.a. Obamacare) go away, there could be some major impacts, as outlined in the letter:
"Specifically, we estimate the following impacts to Washington if the ACA is struck down:
  • Elimination of coverage for 600,000 residents who became newly eligible for Medicaid under the ACA, at a cost of $2.3 billion annually in lost federal funding.
  • Elimination of financial help and likely loss of coverage for 118,000 residents who currently receive federal subsidies to purchase qualified health plans on the Exchange, at a cost of $519 million annually in lost premium tax credits under ACA.
  • A total loss of $2.8 billion annually in federal funds for residents across the state who currently receive free or low-cost coverage under the ACA."
At the state level, Washington has implemented rules to protect many of the same things that the ACA offered, including "prohibitions on annual and lifetime caps, excessive waiting periods, pre-existing conditions exclusions, and gender discrimination," and setting up the state health exchange to be functional even if the ACA is overturned.

However, other protections would be lost if people aren't allowed or able to get coverage anymore, especially under the expanded version of Medicaid, which provides insurance for low income residents.

"The ability to obtain coverage without consideration of pre-existing conditions, and with guaranteed basic and essential health benefits, provides no protection for Washingtonians who simply cannot afford the coverage," the letter states. "A court decision that makes coverage
unaffordable for many would effectively undermine these consumer protections and erode the safety net we have fought to preserve."

Inslee, Kreidler and MacEwan end the letter with a call to Washington's congress members to fight to protect the ACA 

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About The Author

Samantha Wohlfeil

Samantha Wohlfeil covers the environment, rural communities and cultural issues for the Inlander. Since joining the paper in 2017, she's reported how the weeks after getting out of prison can be deadly, how some terminally ill Eastern Washington patients have struggled to access lethal medication, and other sensitive...