President Barack Obama discusses the benefits of the Affordable Care Act during a meeting Feb. 3, 2015, in the Roosevelt Room of the White House with citizens who wrote him about the health care law. 
Alex Wong/Getty Images

A lot of smart people have accumulated quite a bit of data showing how many people, and who specifically, have benefited from the implementation of the Affordable Care Act, otherwise known as Obamacare.

But new questions abound about how many people could be hurt if the law were suddenly stripped away.

That’s the biggest of big-money questions as conservatives push a two-pronged offensive against the law in the Supreme Court and the now fully Republicanized Congress. And it’s an argument being raised—perhaps ironically—by groups that several years ago were some of the fiercest opponents of President Barack Obama’s signature policy achievement back when we were in the throes of a nasty legislative war that scarred relations between the White House and Congress for years to come.

Fast-forward to today, and we find the ACA becoming something of a boon for insurance companies and hospitals. When the threat of a disappearing ACA looms as a conservative Supreme Court deliberates the law’s fate in King v. Burwell, best believe those who stand to lose much will become the law’s loudest supporters.

Hence, arguing in defense of Obamacare, America’s Health Insurance Plans submits a friend of the court brief (pdf) that paints a medically apocalyptic picture should the Affordable Care Act collapse. Referencing Massachusetts’ example as the birthplace of then-Gov. Mitt Romney’s model that inspired the ACA, AHIP and others note that “for every 830 adults gaining insurance coverage there was one fewer death per year,” adding, “[nationally,] 8.2 million people can be expected to lose health insurance in the absence of subsidies on the federal marketplace … [which] equates to over 9,800 additional Americans dying each year.”

Advertisement

So far, 9.5 million people have enrolled in the health care exchanges, a number that’s fast making Obamacare too big to fail. That means if conservatives are successful, quite a few people of color will be on their own, including African Americans and Latinos who have seen their uninsured rates drop significantly by 8 and 10 percent, respectively, as a result of the ACA (though the drop could be even steeper for black folks if certain GOP-held states would accept Medicaid expansion).

We turned to a few noted health care policy experts for The Take on exactly what happens if the Affordable Care Act as we know it disappears … and who would suffer in the process.

Dr. Maya Rockeymoore, Center for Global Policy Solutions: At the end of the day, Obamacare has been responsible for [almost] 10 million people receiving health care coverage, many of whom represent particularly vulnerable populations—Latino, African American, low-income. 

Advertisement

Many Americans will face real consequences: Fewer people will seek important preventive care, serious medical issues will go untreated  and many families will be financially devastated by sky-high medical bills. Those shrugging their shoulders about the thousands who would likely die an early death or struggle with untreated conditions if Obamacare is repealed—and not replaced with an equivalent or better system—fail to consider the steep economic toll this would take on government and industry in the form of greater uncompensated care, lost productivity, and higher incidences of preventable and expensive chronic diseases.

Dr. Ellen Shaffer, EQUAL Health Network: With the implementation of the Affordable Care Act, we’ve witnessed premiums stabilize, and that leads to more healthy people. So in the event this law is repealed or drawn down, 99 percent of those who would otherwise face burdensome or cost-prohibitive premiums if the ACA were not in place will suddenly be back in the same situation. There will be a substantial increase in premiums for 31 percent of single-income households and more than 50 percent of family-income households.

The fact that the ACA is set up the crazy way it is now is because of an insistence on state exchanges when the legislation was being drafted. Gutting the law will destabilize the insurance marketplace. Republicans have had two years to debate this issue and two years to come up with an alternative, and they haven’t. You take away the ACA, rip that cushion from under the health care system and it could create greater chaos than we’ve even seen.

Advertisement

Linda Blumberg, Urban Institute: The number of uninsured people would increase significantly. If the law was repealed in its entirety, the number of people uninsured would be 14.4 million higher than it otherwise would be in 2016. If King wins the Supreme Court case, the number of uninsured would be 8.2 million higher than it otherwise would be in 2016. Those losing premium tax credits under a King victory are most likely to be white non-Hispanics who live in the South and who work full time.

Those keeping their non-group-insurance coverage would face substantially higher premiums, with the average premium per insured person increasing by 35 percent, with many of these people taking less comprehensive coverage due to the premium increases they would face.

Charles D. Ellison is a veteran political strategist and a contributing editor at The Root. He is also Washington correspondent for the Philadelphia Tribune, a frequent contributor to The Hill, the weekly Washington insider for WDAS-FM in Philadelphia and host of The Ellison Report, a weekly public-affairs magazine broadcast and podcast on WEAA 88.9 FM Baltimore. Follow him on Twitter.