A Grave Prognosis for the Affordable Care Act

by Danielle Ofri
New York Times op-ed

After maintaining an oddly low profile early in the election season, health care is a wallflower no more. Last week, the Republican vice-presidential nominee, JD Vance, suggested a second Trump administration might roll back the protections under the Affordable Care Act ensuring that patients with pre-existing conditions are covered. Perhaps he was trying to formulate some “concepts of a plan” that days earlier former President Donald Trump offered during the presidential debate when asked what he had in mind for supplanting the health care law.

Shambolic “repeal and replace” attempts, however, are hardly needed to render a grave prognosis for the Affordable Care Act, the 14-year-old law that provides medical coverage for 45 million Americans. The most virulent threats are proliferating in the judicial system.

This summer, a pair of Supreme Court decisions radically reshaped the health care landscape by overturning the so-called Chevron doctrine. For the past 40 years, this doctrine acknowledged the technical knowledge of scientists and policy experts within federal agencies, giving deference to “reasonable” regulations these agencies issued to interpret ambiguities always present in the complex laws.

In overturning Chevron, the Supreme Court ruled that the courts — not government agencies — should take the lead in clarifying the ambiguities, with Chief Justice John Roberts writing that “agencies have no special competence” in this regard. This significantly weakens the federal agencies’ ability to define the rules that cover health, safety, the environment and other sectors.

(read the full op-ed at The New York Times)