Health Care Leaders: Coverage For Pre-exiting Conditions At Stake In Obamacare Case

1.5 million: That’s how many people who have pre-existing conditions in Connecticut. They constitute nearly half of the state population.

That’s potentially how many people who might lose their health insurance if the Supreme Court repeals the Affordable Care Act (ACA).

Democratic U.S. Sen. Richard Blumenthal issued that warning Tuesday as he spoke alongside state politicians, medical professionals, and healthcare activists at a press conference outside Cornell Scott Hill Health Center on Columbus Avenue.

The press conference focused on President Trump’s Supreme Court nominee, Amy Coney Barrett. Trump and Republican senators are pushing to confirm Barrett ahead of the Nov. 3 general election, cementing a 6 – 3 conservative majority on the court.

Meanwhile, on Nov. 10th, the Supreme Court will hear California v Texas, a case which aims to repeal the ACA (aka ​“Obamacare”).

“The president is nominating a justice who would destroy the Affordable Care Act and reproductive rights,” said Blumenthal. ​“She has said so herself.”

Blumenthal called it highly unusual to try to confirm a justice this close to an election. The latest a justice has been confirmed during an election year is has been late July. Blumenthal stated that he, along with a growing group of Democrats, has refused to meet with Coney Barrett because they object to the process..

“I will vote against this nominee, as well as any nominee, who is part of this sham process of confirmation,” said Sen. Blumenthal. ​”The American people deserve a voice in choosing the next justice, and it should be done by the next senate and the president.”

“We’ve been reaching out to Republicans,” he said later , ​“but only two want to delay the vote. I’m not sure how many others will join them.”

Hitting Close to Home

Even though this process is in Washington, its effects will be deeply felt in New Haven.

“The key element of the ACA is that it protects people who have pre-existing conditions,” said Frances Padilla, president of the Universal Healthcare Foundation ​“My husband, for example, was denied health insurance because of his hypertension and weight. But with ACA, he too was protected.”

The pre-existing condition debate has become especially significant with Covid-19, given that some patients feel the effects long after they have recovered. 

“This repeal could not come at a worse time,” said Michael Taylor, CEO of Cornell Scott Hill Center. ​“Over 7 million Americans have been diagnosed with Covid-19, which has become yet another pre-existing condition.”

Additionally, the ACA expanded Medicaid access for states. This was especially crucial during the pandemic when unemployment skyrocketed. ​“People have lost their jobs and as a result, insurance from their employers,” said Taylor.

“In Connecticut, over 80,000 people signed up for Medicaid over the course of the pandemic,” said Padilla. ​“What will happen to them?”

Padilla is also concerned about the racial effects of repealing the ACA. ​“Black and brown communities in New Haven are more predisposed to have pre-existing conditions,” she said. ​“Those were exacerbated when those same neighborhoods were hit harder with COVID-19.”

Zooming In

“We’ve estimated that about 7,500 of our patients will lose health insurance,” said Taylor. That’s not a small proportion: the Cornell Scott Hill Center system serves 50,000 residents of New Haven County.

Taylor understands the deeply personal impacts of ACA in New Haven. He recalled signing people up for health insurance shortly after the ACA passed. ​“One woman had tears streaming down her face,” he said, ​“because she could finally afford the surgery she knew she needed to have for three years.”

Another man, he recalled, had lost his job and just wanted health insurance for his kids. Overall, Talyor estimated that about 10 percent of Cornell Scott Hill patients gained insurance through the ACA.

The potential loss will affect both the quality and amount of care received.

“The expansion of Medicaid made it much easier for us to meet patients,” said Mark Silvestri, who has worked at the Cornell Scott Hill Center as an ob-gyn for the past seven years. He sees about 700 patients each year, 15 – 20 percent of whom are uninsured.

When patients don’t have insurance, he said, it reduces options for care.

“I was just hearing about a patient who had breast cancer ten years ago,” he said. ​“She should be doing follow-up imaging, but she doesn’t have health insurance. So she could either pay out of pocket or apply for free care, but it’s just so many extra steps.”

Some patients forgo health care altogether. ​“Uninsured patients worry about unexpected bills or large costs,” he said.

He emphasized, however, a ​“Access to Care” team helps uninsured patients sign up for state health care or reduce costs.

This access could become much harder without the ACA. ​“Taking pre-existing conditions into consideration for insurance could be devastating,” Silvestri said. ​“Everyone has a pre-existing condition at some time or another; that’s being human.”

Taylor is not convinced by the Trump administration’s promises that people will remain protected. ​“The alternative is a phantom plan,” he said. ​“We have no idea what’s in it, and we can’t risk that.”

Blumenthal put it most succinctly: ​“There will be a humanitarian crisis.”