The Supreme Court will take a look at another challenge of the constitutionality of the Affordable Care Act, or Obamacare, in the fall.


On Nov. 10, the Trump Administration will attempt to persuade the U.S. Supreme Court to invalidate the Affordable Care Act. If the administration wins, insurance companies will once again be able to deny coverage or charge sky-high rates to people with pre-existing conditions. Caps on lifetime spending for individual health care will return. Adult children under age 26 will no longer have the option to be covered by a parent’s health insurance.   

As a children’s hospital CEO, I see health care through the eyes of sick kids and desperate parents. When a child is sick, access to timely diagnosis and treatment is paramount. Politics becomes irrelevant. 

At children’s hospitals across the country, nearly every hospitalized patient has some type of pre-existing medical condition. And at my hospital, which treats kids with special medical needs, the elimination of lifetime spending caps is critical for patients requiring ongoing physical, occupational, and speech therapy along with medical surveillance. The prospect of losing these two protections is terrifying for these parents. I know. I speak with them all the time.   

But what might it be like for you? Did you know pre-existing conditions can include arthritis, asthma, cancer, diabetes, epilepsy and lupus? Or how expensive cancer treatment, or a severe case of the coronavirus can be? And that the long-term effects of COVD-19 are now considered a pre-existing medical condition? Perhaps you have a child or family member under 26 who’s lost a job but now can no longer be insured under your plan. What would you do? 

Advocating for continued protections under the Affordable Care Act should be bipartisan, because those are its roots. In 1989, Stuart Butler of the conservative Heritage Foundation formulated a market-based policy solution to insure Americans without health insurance. In his paper, “Assuring Affordable Health Care for All Americans,” Butler argued that competition among health insurance companies would lower prices and present choices to consumers. This logic was adopted by both political parties. Even the individual mandate wasn’t originally an Obama-Democratic idea; it, too, was born at the Heritage Foundation. Thus, a conservative think tank paper became the basis for the key elements of the Affordable Care Act. Yet in the midst of the most devastating health crisis this country has faced in 100 years, the Administration is attempting to eliminate it.   

I’d ask two simple interrelated questions of any legislator who is against the ACA, but claims to be in favor of keeping protections for pre-existing medical conditions and prohibiting lifetime spending caps: 

  1. Why is our government arguing in the U.S. Supreme Court to overturn the Affordable Care Act?
  2. What specific legislation have you sponsored, co-sponsored or supported to replace the ACA but keep these protections?

In nearly four years of fighting the ACA — even while a pandemic rages, afflicting nearly 7 million Americans, claiming more than 210,000 lives, and resulting in unemployment and loss of health insurance for 27 million Americans — no new health legislation has been proposed to replace the Affordable Care Act. 

The debate over a Public Option, Medicare for All, or other health policy alternatives will be an important one for a future time. But for now, to overcome the monumental crises we currently face, we need to hold on to the protections we already have. 

This November, we need to make sure that our health care is protected by the U.S. Senate, House of Representatives and the Supreme Court. We need to vote, and to hold our candidates and elected representatives responsible. Because, quite literally, our lives depend on them. 

Larry Levine is the President and CEO of Blythedale Children’s Hospital in Valhalla, New York. 

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