Attacks on the ACA


Texas v. US

On Dec. 14, 2018, a federal judge in Texas issued a decision declaring the “individual mandate” –  the individual-coverage requirement – unconstitutional, and even more drastically, invalidating the Affordable Care Act (ACA). So far, the decision does not affect 2019 enrollment or coverage.  The ACA is still here. We expect the matter will ultimately go to the Supreme Court, though this process will take some time. 

Texas v. United States: Defending Discrimination

Overview of  Attack on the Affordable Care Act (ACA)

On January 20, 2017, the same day that he was inaugurated, President Trump issued an Executive Order stating that his Administration would try to repeal the ACA as quickly as possible.

Although Congress was not able to repeal and replace the ACA through the formal law-making process, the President and various agencies in the Executive Branch have taken significant steps to change and undermine different sections of the ACA. All of these attacks have the same effect: they make it more expensive and harder for people with disabilities and other pre-existing conditions to get health care.

What are Pre-Existing Conditions?

The ACA made it illegal for health insurers to discriminate against people based on pre-existing conditions, which includes any health problems or even life circumstances that you have before you get that insurance. Before the ACA, an insurance company could deny people or charge them more for coverage if they had any medical condition or disability. As a result, people with disabilities had fewer options for health insurance, and they had to pay more money than people without disabilities for the same services. Under the ACA, health insurers must treat people with different health conditions equally. They are not allowed to deny coverage, impose higher costs, or limit access to services for people with pre-existing conditions. And yet, the current Administration is finding all of the ways to bring back this form of discrimination against people with disabilities.

Sham Plans: Devastating the Individual Marketplace
Repealing the Individual Mandate
Shutting Down Subsidies
Protecting the ACA and Pre-Existing Condition Coverage in the 116th Congress
The President's Budget for FY 2020
Repeal and Replace: Before 2019

What’s the Effect? Higher Costs for Everyone

When people with fewer health care needs stop buying full coverage, insurance companies need to raise the price of coverage for the people who know they need to access health care services throughout the year. People with pre-existing conditions and people with disabilities end up facing the same problems as before the ACA, where they have fewer choices and more expensive health care. People who buy these limited plans are not much better off, since they have to pay much more for health care services as issues come up that they cannot predict. When they develop chronic conditions, their insurance does not cover the care they need, and they need to pay for these services on their own.

This disconnected, discriminatory, and misleading system hurts everyone, but it is immediately threatening for people with disabilities. Learn about how you can act now to stop these efforts to take health care away from those who need it!


ACA Repeal Bills Would Do Much the Same Damage as Judge’s Decision to Strike Down the Law, CBPP (12/17/18)

Sabotage Watch: Tracking Efforts to Undermine the ACA, CBPP (2018)

Five Ways the Trump Administration and Republican Leaders Have Sabotaged Health Insurance Enrollment, FamiliesUSA (Dec. 2018)

Health Care Threat Tracker, FamiliesUSA (2017)

Pre-existing Conditions and Medical Underwriting in the Individual Insurance Market Prior to the ACA, Kaiser Family Foundation (12/12/16)

Response to the Federal Government, Consortium for Citizens with Disabilities (7/12/17)

The Trump Administration’s Hidden Attacks on the Affordable Care Act, The Washington Post (1/5/18)

Proposals for Insurance Options that Don’t Comply with ACA Rules: Trade-Offs in Cost and Regulation, Kaiser Family Foundation (4/18/18)

Short-Term Plans Do Not Cover Life-Saving Mental Health and Substance Use Treatment, Families USA (6/19/18)

Unpacking the Final 2019 Payment Notice, Part IPart II, and Part III, Health Affairs (4/10/18)

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