Inslee, Kreidler, and MacEwan write letter warning of “widespread and devastating” impacts if ACA is overturned

In the wake of Supreme Court nominee Amy Coney Barrett’s confirmation hearing, Governor Jay Inslee sent a letter to US Senators Patty Murray and Maria Cantwell on Thursday highlighting the potential “widespread and devastating” impacts on Washington if the Supreme Court strikes down the Affordable Care Act (ACA). Insurance Commissioner Mike Kreidler and Washington Health Benefit Exchange CEO Pam MacEwan joined Inslee in signing the letter.

In less than a month, the Supreme Court will take up the California v. Texas lawsuit which threatens to dismantle the ACA. Inslee, Kreidler, and MacEwan say a Barrett confirmation is a significant threat to the landmark health legislation.



“Given that President Trump has publicly committed to nominating judges who will ‘terminate’ the law, his administration’s explicit support of this lawsuit, and Judge Barrett’s own record questioning previous U.S. Supreme Court decisions upholding the ACA, we are gravely concerned that a vote to confirm her to the Court would be a vote to repeal health care for hundreds of thousands of our people,” they write.

If the ACA is struck down, the letter states that 625,000 Washingtonians who became newly eligible for Medicaid under the ACA would lose coverage, resulting in a $3.6 billion annual loss in federal funding. Without the ACA, 140,000 residents who rely on federal subsidies to purchase qualified health plans on the Exchange would lose the financial help.

The state leaders anticipate a total loss of over $4.2 billion annually in federal funds for residents who receive low-cost or free coverage under the ACA.

The letter notes that while Washington State has embedded some ACA provisions into state law, such as  protections against pre-existing conditions exclusions, the elimination of the ACA would have a profound impact on the state.

“However, a decision overturning the ACA would render many of these protections useless for the hundreds of thousands of Washingtonians that could be thrown off their health plans. The ability to obtain coverage without consideration of pre-existing conditions, and with guaranteed basic and essential health benefits, provides no protection for Washingtonians who simply cannot afford the coverage. This would have massive implications for people with pre-existing conditions and others who rely on the law’s reforms, such as women and older adults. A court decision that makes coverage unaffordable for many would effectively undermine these consumer protections and erode the safety net we have fought to preserve,” they write.

The impacts of eliminating the ACA would be particularly harmful during the COVID-19 pandemic, they write.

“That a decision could be handed down in the midst of the COVID-19 pandemic and our nation’s ongoing efforts to recover only intensifies the harm. More than 90,000 Washingtonians will have a new pre-existing condition this year after having been diagnosed with COVID-19.”

Over 800,000 Washingtonians have gained coverage through Medicaid expansion and through the Washington Health Benefit Exchange since the enactment of the ACA. During that time, Washington’s uninsured rate dropped from 14% to 5.5% in 2019, according to the letter. The pandemic has already caused over 100,000 Washingtonians to lose health coverage this year, and as of September 2020, the state’s uninsured rate has grown back to 8%, they say.

The three leaders say the ACA has also been integral to expanding coverage options during the pandemic and to the state’s ongoing work in addressing health disparities.

“The stakes could not be higher,” they write.