MEMPHIS, Tenn. (WMC) - The U.S. Supreme Court heard oral arguments Tuesday on the Affordable Care Act, more specifically, the individual mandate, or requirement that all Americans obtain health insurance.
Eighteen states including Tennessee, Mississippi, and Arkansas are part of the legal push asking the court to invalidate the entire law, which would remove guaranteed coverage for pre-existing conditions.
Two conservative justices, Chief Justice Roberts and Justice Brett Kavanaugh signaled during oral arguments Tuesday the entire law may not go down.
But in Tennessee proponents of the ACA said the law isn’t operating as it should because the state of Tennessee never expanded Medicaid.
“It’s better than nothing if you have a catastrophic illness. But it’s not in my mind what we would consider to be real health insurance,” said Dr. Scott Morris at Church Health.
Morris said the ACA in Tennessee is hanging on, but the system is not operating as it should. Residents can buy health insurance on the marketplace, but the policies have high deductibles. Those obtaining a policy on the marketplace must have income above 138% of the poverty level.
The poorest are left out, he said.
“The failure to expand Medicaid has made it where a person who is working a low wage job is just not going to qualify,” said Morris.
In a special session in 2015, Tennessee lawmakers declined to advance Insure Tennessee, a Medicaid expansion program proposed by then-Governor Bill Haslam, a Republican.
The Beacon Center of Tennessee, a conservative think-tank, fought against it. Leaders there told WMC Action News 5 on Tuesday telemedicine and direct primary care, where insurance is left out, present options for lower income residents.
“We’ve never thought that government insurance was the answer to that. And we’ve always thought it is better to look to the private market, for different, more unique ways to come up with solutions rather than just turn to a government program,” said Stephanie Whitt, Executive Vice-President, Beacon Center of Tennessee.
In 2020, 200,445 Tennesseans obtained healthcare through the marketplace, followed by 98,892 Mississippians and 64,360 Arkansans.
Arkansas expanded Medicaid in 2018 but implemented work requirements that kicked some people off the rolls. The work requirements were halted by appellate courts.
Like Tennessee, Mississippi has not expanded Medicaid under the ACA.
Morris said given the piecemeal application of the law in Tennessee, those who need insurance the most aren’t getting it.
“We have to realize that the people who are being left uncared for are the people who work to make our lives comfortable. They cook our food. They take care of our children. They wash our dishes. They cut our grass, and they will one day dig our graves. Yet when they get sick their options are very few,” he said.
A decision from the Supreme Court is expected next spring. Currently, 20 million Americans depend on the ACA for their healthcare.