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For the 61 million Americans who live with a disability, there’s an important date on the calendar this fall: November 10, the day the Supreme Court will hear a case about whether to overturn the Affordable Care Act. President Donald Trump and Senate Republicans have picked a Supreme Court nominee whose position is clear: she doesn’t like the ACA, or the previous court rulings that upheld it. There is so much at stake.
Before the ACA, the disability community faced critical barriers to high-quality medical care. Health insurers could deny or cancel coverage for people with pre-existing conditions — including millions of people with disabilities. Insurers regularly imposed “lifetime limits” on their coverage, a gut punch for people with disabilities whose medical needs cost a lot of money. For babies born prematurely and children with disabilities, this sometimes meant hitting their lifetime caps before they were even old enough for school.
This lack of basic health protections put people with disabilities in an economic bind, too. Many were forced to hold on to dead-end, low-paying jobs for the sake of keeping health insurance they couldn’t find anywhere else. Meanwhile, if people with disabilities couldn’t find insurance and had to turn to Medicaid, they could only qualify by going through a cumbersome disability determination process and declaring their inability to work. If they wanted to work, they were forced to give up their insurance — an impossible choice no one should have to make.
... overturning the ACA would reverse all the important gains we’ve made.
The ACA made a lot of progress. It banned the cruel practice of lifetime limits, ensuring that children with disabilities and their families won’t have to go bankrupt to get the care they need. It protected people with pre-existing conditions. It ensured that people with disabilities could buy insurance in the Marketplace and expanded the Medicaid program, making it easier to get high-quality, affordable care without leaving the job market. In fact, Medicaid expansion increased employment rates among people with disabilities. And for young people with disabilities, being able to stay on their parents’ insurance until the age of 26 means the opportunity to build a career for themselves, without having to worry about whether they will continue to have access to life-saving health care.
The ACA didn’t just expand access to health insurance. It also meant that people with disabilities could actually get the high-quality services and treatments they need. The Community First Choice Program in the ACA helps states provide home- and community-based services that allow people with disabilities to live with their families and in the community, rather than in institutions. Especially at a time when people living in nursing homes, assisted living facilities, and group homes are at heightened risk from the COVID-19 pandemic, these supports are more crucial than ever. We still have a long way to go: I’m fighting in Congress for better funding for home- and community-based services and better oversight of nursing homes and assisted living centers. But overturning the ACA would reverse all the important gains we’ve made.
The ACA also ensured that mental health care is treated as exactly what it is: health care. People with disabilities have higher rates of depression and may face barriers to getting treatment for mental and behavioral health conditions. The ACA made mental and behavioral health treatment an Essential Health Benefit — one that all insurers are required to cover.
But we won’t tolerate it. Disabled people are used to uphill battles, and they know how to persist.
All of these guarantees were important before the pandemic, but they are even more essential now. More than 7 million people in the United States have been diagnosed with COVID-19. Many of these survivors may have long-lasting health effects that we are only beginning to understand. In other words, the number of Americans with pre-existing conditions is growing every day. Without the ACA in place, anyone who ever tested positive for COVID-19 could be denied coverage because of a pre-existing condition. At the same time, economic turmoil and social isolation have created a mental health crisis. There has never been a greater need for quality, accessible, affordable mental health care.
With the election just days away, the president, Senate Majority Leader Mitch McConnell, and their enablers are trying to ram through Amy Coney Barrett’s nomination before the American people have a chance to make their voice heard. They want her on the bench on November 10 to help accomplish what Republicans have been trying to do since the beginning: end the ACA and rip health care away from 21 million people, including millions of people with disabilities.
But we won’t tolerate it. Disabled people are used to uphill battles, and they know how to persist. Together, we’re fighting to stop this nomination and to make our voices heard by sharing our stories and voting to protect the health care that people with disabilities — and all Americans — deserve.
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