USA TODAY

On Tuesday, a three-judge panel of the U.S. Court of Appeals for the Fifth Circuit heard oral arguments in a case challenging the constitutionality of the Affordable Care Act, popularly known as "Obamacare." If the suit is successful, the health care law is likely to go before the Supreme Court for a third time.

There is no replacement for our care

By EJ Montini

There has been so much tawdry and titillating news this week, you may not have noticed that people you elected took another step toward killing your health care. And perhaps indirectly ... you.

Republican attorneys general (supported by President Donald Trump) filed a lawsuit to kill the Affordable Care Act, a case heard this week by a federal appeals court in New Orleans.

If the lawsuit succeeds (it may well end up at the Supreme Court), the prohibitions against being denied health care coverage for preexisting conditions will disappear and Obamacare would suddenly cease to exist, more than 20 million Americans could find themselves without health insurance. Just like that.

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If that were to occur, with no replacement plan in place (and there is none), people would die. There is no way around it.

Uninsured individuals with no access to medical care will fall victim to otherwise preventable or treatable illnesses.

And that isn’t the only impact. There are major provisions of Obamacare that Americans agree with. They, too, would disappear. Like allowing young people to stay on their parents’ insurance until the age of 26.

And reductions in Medicare costs ranging from drug coverage to premiums. Caps on out-of-pocket spending would disappear. As would prohibitions on things like lifetime limits.

It goes on.

A bipartisan group of economists and health care experts, in a friend-of-the-court brief, said "billions of dollars of private and public investment — impacting every corner of the American health system — have been made based on the existence of the ACA," and that abolishing the law "would upend all of those settled expectations and throw healthcare markets, and 1/5 of the economy, into chaos."

There are Democratic attorneys general fighting to save the law.

California's Xavier Becerra said in a statement, "Our argument is simple. The health and well-being of nearly every American is at risk. Health care can mean the difference between life and death, financial stability and bankruptcy. Our families' well-being should not be treated as a political football."

For one thing — one very important thing — there is no replacement.

Sen. Martha McSally, R-Ariz., while in the House, supported efforts to repeal the law and has said of the legal case that it is not her role to decide. Her spokeswoman says she favors covering those with preexisting conditions. But they all say that, knowing how much Americans like it.

However, there is no agreed upon plan. An nothing to deal with all of the other ramifications of abolishing the law.

Not that people involved in the lawsuit like Arizona Attorney General Mark Brnovich seem troubled. Well-fixed attorneys usually have decent health care coverage.

He said of killing the law, "My hope is that Congress will step up and actually do their job. My role is to enforce the Constitution, not make policy. I did my job; it’s time for Congress to do theirs."

As for all those Americans potentially devastated by the lawsuit, people who elected Brnovich, Trump and other Republicans, well, they’ll be on their own.

EJ Montini is a columnist at the Arizona Republic, where this column originally appeared. Follow him on Twitter @ejmontini.

What others are saying

Ken Paxton, Fox News: "Obamacare is often billed as comprehensive 'health care reform.' But what it really did was to abruptly freeze health care reforms being carried out by the 50 states. Any further innovation by the states will need Congress’ blessing to proceed. That’s not progress, it’s politics as usual. When Obamacare is struck down once and for all, legislators across the country can get back to crafting policies that address the needs, and conform with the values, of their own residents."

Ezra Klein, Vox: "If you want to know why Democrats are dotting the landscape with new proposals for 'Medicare for All' and 'Medicaid for All,' this ruling is a useful artifact. The basic idea behind Obamacare was that a public-private system based on Mitt Romney’s Massachusetts reforms would command some Republican support, or at least acceptance, and thus be easier to pass and to expand. Republicans have proved that theory wrong. Instead, the private-public construction of Obamacare has given opportunistic Republicans their most effective attacks on the bill. Those attacks have been legal, like this assault on the regulations governing private insurance purchase; and political, like the ads slamming high deductibles and complex shopping schemes and Medicare spending cuts."

Ganesh Sitaraman and Anne L. Alstott, The New York Times: "Americans don’t need to resign themselves to vicious capitalism, just as generations before us didn’t. And the idea that public action and markets are incompatible is simply false. We don’t have to choose between competitive markets and equal opportunity. Public options are a way to mitigate the damage that comes with the worst aspects of capitalism while creating a common fabric that ties us together."

Jason Sattler, USA TODAY: "A Harvard study of the Massachusetts law that served as the model for the ACA found 'one life saved for each 830 people gaining insurance.' This means if Republicans in Congress had finished off the law they've spent a decade vowing to kill, they would have put thousands of lives at risk. But that’s the genius of the GOP’s focus on the courts. With an appointment that lasts a lifetime, you don’t have to worry about the consequences of leaving 20 million uninsured."

What readers are saying

The ACA has just thrown a wrench into everything. We do need a replacement, which is why we need people ... in Congress working to get it done.

— Liam Johnson

Having the government make things easy for Americans is tempting, but it is a road to ruin. If you feel health care needs to be improved, do it without government involvement.

— Michael Segreto

For over eight years the Republicans have been saying "repeal and replace," but have not come up with an alternative plan.

— Jeff Ray

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