What does the Affordable Care Act do?

The Trump administration urged the Supreme Court to overturn the Affordable Care Act, even as the coronavirus pandemic and subsequent economic shutdown continue to trigger millions of layoffs.

In a filing late Thursday, the administration told the court that "the entire ACA must fall," reiterating President Trump's stance that the Obama-era health law must be struck down as unconstitutional.

VIRUS TREATMENT COULD EXCEED $1,300 FOR INSURED AMERICANS

In the case before the Supreme Court, Texas and a slew of other Republican-led states argued the ACA, also known as ObamaCare, was unconstitutional because the 2017 Tax Cuts and Jobs Act stripped the financial penalty for Americans who did not get health insurance but had kept intact the individual mandate that required virtually everyone to have coverage.

If the 10-year-old law is repealed, it could leave an estimated 32 million people uninsured by 2026, according to a Congressional Budget Office report from 2017.

WHAT IS MEDICAID AND HOW DO YOU GET IT?

The law, signed by former President Barack Obama in 2010, expanded health insurance to millions of Americans by reforming how coverage works in the country. It has survived multiple legal challenges; in 2012, the Supreme Court upheld the law, saying the individual mandate, which required Americans to either purchase coverage or pay a penalty, was authorized by Congress' power to levy taxes.

“The Affordable Care Act’s requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax,” Chief Justice John Roberts wrote in the majority opinion. “Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.”

The law has three primary purposes:

1. Make health insurance affordable to more people. The law stipulates that households with incomes between 100 percent and 400 percent of the federal poverty level can receive subsidies, or premium tax credits, that lower their overall costs 
2. Expand Medicaid to cover all adults with income below 138 percent of the federal poverty line 
3. Support innovate medical care delivery methods designed to lower the costs of health care in general

WHAT IS MEDICARE AND HOW DO YOU GET IT?

Premiums for policies purchased through marketplaces or directly from insurers could spike by 20 percent to 25 percent in the first new plan year, following the enactment, according to the CBO. By 2026, the increase is expected to climb to 50 percent following the elimination of the Medicaid expansion. Average premiums would also likely spike as a result.

If the law is struck down, more than 12 million low-income adults could lose the Medicaid coverage they’ve gained as a result of the ACA.

But perhaps most notable are the Americans living with pre-existing conditions who would lose their coverage. Under the law, insurance companies are prohibited from asking about pre-existing conditions, or medical conditions that people already have when they're shopping for a plan. It could range from diabetes to cancer, and health insurance companies could charge more, or deny coverage, to individuals who had them.

WHAT HAPPENS TO YOUR HEALTH INSURANCE IF YOU LOSE YOUR JOB?

According to a government analysis from 2017, an estimated 51 percent of Americans live with pre-existing conditions -- or about 113 million people. Prior to the implementation of the ACA, any of these people could have been denied coverage.

Still, by no means did the ACA create universal coverage. Even with the law and individual mandate fully intact, the CBO estimated that 31 million people lacked coverage.

Individuals cannot buy health care year-round through ObamaCare. There is an annual enrollment period that typically starts in November. However, there are some exceptions to this rule. If you lose your job, or get married, or have a baby, you may qualify for a special enrollment period.

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