SCOTUS Could Overturn Health Care for Millions of Children

By: Sarah Vidrine | October 2020

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Last week we reported on the dramatic losses in health coverage that North Carolina children have experienced since 2016. On November 10, 2020, just one week after Election Day, the Supreme Court will hear oral arguments in the latest health care repeal lawsuit. The fate of the Affordable Care Act (ACA) – and health coverage for tens of millions of Americans, including millions of children – will hang in the balance. 

Children made huge gains in health coverage under the Affordable Care Act — particularly Black, Latinx, and Native children. Overturning the ACA would be disastrous for the health and economic security of North Carolina families. If the SCOTUS overturns the ACA, an estimated 387,000 North Carolinians will lose their health coverage – increasing the rolls of the uninsured in our state by over 30%, according to new estimates from the Urban Institute. This is one of largest projected losses of insurance in the country. 

We can’t afford to put any more children at risk of losing coverage. An estimated 142,000 North Carolina children were uninsured last year — a number that has been increasing since 2016. More are expected to lose coverage in 2020 as a result of the economic downturn and associated job losses.

Legal Analysis 

The case at hand, California v. Texas, represents a challenge to the entirety of the ACA. This is the third legal challenge since the law was enacted in 2010. With the previous two attempts to dismantle the law, National Federation of Independent Business v. Sebelius (NFIB) and King v. Burwell, Chief Justice John Roberts wrote the majority opinions upholding the ACA. 

With the death of Justice Ruth Bader Ginsburg just weeks ago, and Senate leadership rushing to confirm Judge Amy Coney Barrett’s nomination by President Trump, ACA supporters are worried. In previous interviews and writing, Judge Barrett has publicly criticized and critiqued the Chief Justice’s decisions, even stating that the majority’s decision in King was wrongly decided, and that the dissent had the “better of the legal argument.” 

Overturning ACA would create chaos and increase discrimination 

Thanks to decades of hard work and the ACA’s passage, the rate of uninsured children in North Carolina reached historic low levels in 2015. Families have benefited from the expansion of health care access, protections, and coverage. 

If the ACA is overturned, Black, Native, and Latinx Americans who have been disproportionately harmed by COVID-19 would lose insurance in staggering numbers.

Before the ACA, insurers could discriminate against people with pre-existing conditions. Children with special health care needs and chronic health conditions were often charged higher premiums, excluded from coverage, or denied coverage outright. The ACA also bans lifetime or annual limits that would cap how much an insurer would pay for medical care each year or over a person’s lifetime. These limits were devastating for families of children with special health care needs.

We can’t move backwards. Kids and their families need reliable health coverage, preventive health care, and access to medical providers more than ever. Whatever the fate of the Affordable Care Act, this is a critical time for children’s health. Whether you are a parent, pediatrician, teacher, service provider, or elected official, your voice is crucial. We won’t stop fighting for children’s health until every child has the coverage and the care they need.