Colorado health care advocates defended the Affordable Care Act (ACA) on Monday, the day before the U.S. Supreme Court will hear the oral arguments for California v. Texas, a case that will decide the fate of the ACA. The GOP and Donald Trump have supported the lawsuit that became California v. Texas in an effort to repeal the act. 

During a virtual news conference organized by Colorado Protect Our Care, a group fighting Republican efforts to repeal the ACA, experts used the Coronavirus pandemic to highlight how essential the act is to marginalized communities.

According to the think tank Urban Institute, overturning the ACA would make an additional 21.1 million people uninsured nationwide, a 69% increase. If it is repealed, Colorado would have the 4th largest percent decrease in federal healthcare funding among U.S. states.

Laura Packard, Denver-based health care advocate and stage four cancer survivor, said she takes the threat of losing the ACA personally because it is how she is able to afford her insurance. Protections for people with pre-existing conditions in the ACA prohibit insurance companies from overcharging Packard. Her market-rate policy is affordable, but without the ACA she said she becomes uninsurable.

“If I lose my insurance and my cancer comes back I will be bankrupt or dead. And my story is not unique,” Packard said. “I don’t know what we do if the Supreme Court votes to destroy the Affordable Care Act because we can’t go back. In the days before the ACA what happened to people like me is that we died.”

Packard also talked about fears that COVID-19 could be considered a pre-existing condition, allowing insurance companies to deny coverage if the ACA were repealed. The fear is a valid one, and Packard mentioned that another concern could arise once a Coronavirus vaccine is created.

“There was great news from Pfizer today about their Coronavirus vaccine, but the mechanism that enables people to have these vaccines free of charge, which are essential health benefits, is part of the Affordable Care Act,” Packard said. “So, if they take an ax to the Affordable Care Act, what does that do to our entire plan to distribute vaccines to Americans?”

A distribution plan for a COVID-19 vaccine would be essential to curbing future spikes in cases, according to national public health experts. Governor Jared Polis, a Democrat, announced that Colorado could get up to 200,000 doses of the vaccine, but not until the early months of 2021.

The conversation turned to how COVID-19 has disproportionally affected communities of color, who are already disproportionally uninsured.

Studies from the Kaiser Family Foundation (KFF), a non-profit health policy organization, found that the act helped narrow disparities in healthcare coverage between communities of color and white people.

Those disparities are not completely eliminated, but other studies corroborated KFF’s findings that people of color would likely experience the largest coverage loss if ACA was repealed.

Rayna Hetlage, policy manager for the Center for Health Progress, an advocacy group for health care equity, emphasized the benefits of the ACA on marginalized populations.

“We know that COVID is impacting Black and Hispanic people at far higher rates than white people,” Hetlage said. “If that is considered a pre-existing condition, with no ACA, what we’re also going to see is a widening gap in lack of coverage for Black and Hispanic people in our country.”

More people are struggling with mental health issues during the pandemic and many rely on the ACA for treatment, according to Moe Keller, director of advocacy for Mental Health Colorado who served in the Colorado Senate and House of Representatives for 16 years in total.

Keller said that Mental Health Colorado, a mental health advocacy group, has seen a 400% increase in clinical anxiety and 500% increase in depression during the public health crisis. The highest increases have been in people between the ages of 14 and 24.

Keller explained how before the ACA was passed, people with mental health conditions and substance abuse issues — considered pre-existing conditions — were not offered the treatments and services they needed from their private health insurance companies. After the passage of the ACA, coverage for mental health and substance abuse issues was included as a defined benefit in private health insurance plans and young people were allowed to stay on their parent’s health insurance plans until they turned 26.

“[The ACA] was, and remains, a huge advance in health care coverage,” Keller said. “A repeal of the Affordable Care Act would be devastating to millions of Americans and their families. It’s not ok to go back to the dark days of no mental health coverage or services. At a time when this country is facing a public health crisis unlike any before, eliminating health care access for 20 million citizens is neither cost-efficient nor constructive.”

Julie Reiskin, executive director of the Colorado Cross-Disability Coalition (CCDC), a statewide organization focusing on disability rights, shared how people with disabilities especially value healthcare accessibility.

“We care about health for everyone, whether or not they have a disability. People with disabilities are the canaries in the coal mine of healthcare; what does not work for us will kill us first, but what works for us will work for everyone,” Reiskin said. “Of course, the ACA needs improvements, and those improvements relate to the costs and limits of private insurance. Decimating the ACA will not solve those problems it will just kill off many of us canaries.”

You can listen to the arguments in California v. Texas, which are being conducted over the phone by clicking this link to C-SPAN. Arguments start today at 10 a.m.

The case has the backing of the Trump administration and was set in motion by Republican attorneys general.