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Successful GOP Repeal of ACA Would Strip Health Coverage From Millions and Give Top 0.1% a Massive Tax Cut—During a Pandemic

"If Trump gets the Supreme Court to strike down ACA, the richest 0.1% would get a tax cut of $198,000 a year, and Big Pharma would get a tax cut of $2.8 billion. But millions of seniors would pay billions more for prescription drugs, and 20 million would lose their health insurance."

Participants hold signs while protesting efforts made by President Donald Trump and Republican legislators to the repeal the Affordable Care Act at a demonstration in New York City on July 29, 2017. (Photo: Albin Lohr-Jones/Pacific Press/LightRocket via Getty Images)

Participants hold signs while protesting efforts made by President Donald Trump and Republican legislators to the repeal the Affordable Care Act at a demonstration in New York City on July 29, 2017. (Photo: Albin Lohr-Jones/Pacific Press/LightRocket via Getty Images)

New research released Tuesday shows that if the Supreme Court next month sides with the Trump administration and 18 state attorneys general seeking to repeal the Affordable Care Act, more than 20 million people would lose health insurance and millions more would be forced to pay more for healthcare—in the middle of a pandemic—while Big Pharma and the richest 0.1% would enjoy major tax cuts. 

"The stakes in this case, always extraordinarily high"—wrote Tara Straw and Aviva Aron-Dine in one of several reports (pdf) published this week by the Center on Budget and Policy Priorities (CBPP)—"are even higher now amidst a global pandemic and an economic crisis that has caused more people to lose health insurance and become eligible for help from the ACA."

Last week, President Donald Trump claimed on Twitter that a Supreme Court decision striking down the ACA "would be a big WIN for the USA!" Trump said that he would replace "Obamacare" with something "MUCH better," but another new report (pdf) from CBPP shows that "none of the supposed alternatives to the ACA offered by the Trump administration or congressional Republicans" would protect people with pre-existing conditions. 

Countering Trump's assertion that eliminating the ACA would be a national victory, economist and former labor secretary Robert Reich explained exactly which class of Americans would win and who would lose were the law to be repealed during a pandemic and recession. 

"While the legal arguments against the law are extremely weak," Straw and Aron-Dine explained, the Republican Party's efforts to overturn the ACA have been given a boost by the death of Justice Ruth Bader Ginsburg and the president's nomination of Judge Amy Coney Barrett, "who has been critical of the Supreme Court's reasoning for upholding the ACA in prior cases."

The GOP-led Senate has made expediting Barrett's confirmation a priority, even as an overwhelming majority of voters have indicated that they would prefer for Congress to pass an economic relief package, as Federal Reserve Chair Jerome Powell also recommended Tuesday hours before Trump announced that he was postponing stimulus negotiations until after the election. 

According to Straw and Aron-Dine, overturning the ACA "was expected to cause 20 million people to lose coverage" prior to the economic crisis. "If the law were struck down during a recession... millions more would likely lose coverage... with commensurately larger impacts on access to care, financial security, health outcomes, and racial disparities in coverage and access to care."

Repealing the ACA in the midst of a pandemic "would also impede efforts to address the public health crisis," Straw and Aron-Dine wrote, and the elimination of "the ACA's protections for people with pre-existing conditions could make it harder for the more than 7 million people who've had COVID to obtain affordable, comprehensive coverage in the future."

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Not only would striking down the ACA directly harm tens of millions of Americans "covered through the ACA marketplaces or benefiting from its protections for people with pre-existing conditions," explained CBPP senior policy analyst Jessica Schubel, but it would cause additional damage by disrupting Medicare and "jeopardizing states' ability to administer their Medicaid programs even for those who remain eligible." 

In contrast to all of the ways that a successful GOP repeal of the ACA would hurt working class Americans by undermining their access to healthcare amid the coronavirus crisis, millionaires and Big Pharma would stand to pocket massive amounts of cash.  

"This doesn't get the attention it should," tweeted CBPP senior health policy fellow Judy Solomon. "If the Trump administration succeeds in overturning the ACA, not only will millions lose health coverage, but millionaires will get big tax cuts."

According to CBPP, if the ACA is struck down, the highest-income households in the country would be given a "windfall." The richest 0.1% of households, whose annual incomes are greater than $3 million, would receive tax cuts averaging nearly $200,000 per year, while households with annual incomes over $1 million would receive tax cuts averaging over $40,000 per year.

The cost to the federal government of tax cuts for households with annual incomes over $200,000 would be $30 billion in 2020, which is more than one-third of the cost of the ACA's expansion of Medicaid to low-income adults—enough to "pay for health coverage for over four million people."

Other beneficiaries of an ACA repeal would be pharmaceutical companies, which would pay $2.8 billion less in taxes each year. Big Pharma's victory would come at the expense of millions of seniors who would pay billions more each year for prescription drugs. 

The Wall Street Journal reported earlier this year that many wealthy Americans rushed to file claims for refunds of ACA taxes paid in previous years in case the Supreme Court invalidates the law. 

With Trump out of the hospital Monday and still battling his own Covid-19 infection, Reich provided a reminder that "our tax-dodging billionaire president is getting publicly-funded healthcare while his lawyers are in court trying to rip yours away."

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