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A recent study indicates the ACA repeal will force seniors to pay more while pharmaceutical companies profit billions in tax breaks.

Millions of older Americans will see their prescription drug costs surge if the Affordable Care Act (ACA) is repealed, according to a new study released this week by the Center on Budget and Policy Priorities (CBPP).

The study found that ACA repeal would cause five million seniors to pay at least $1,000 more per year, on average, for prescription drugs, while providing pharmaceutical companies with $2.8 billion in tax breaks each year. This comes on top of the well-established “age tax” that Americans over 50 would be saddled with should the ACA be struck down. 

The report’s release comes as the U.S. Court of Appeals for the 5th Circuit is expected to issue a ruling in the coming weeks regarding a 2018 lawsuit filed by Arizona and 19 other Republican-led states seeking to repeal the entire ACA.

Should the Court side with Republican states, the case would likely be appealed to the Supreme Court, which would then determine the ACA’s ultimate fate, and with it, the cost of health care for older Arizonans.

If the ACA is struck down, “millions of older adults will lose the health care coverage and consumer protections they have relied on for years,” the AARP said in an amicus brief filed with United States Court of Appeals for the Fifth Circuit in April 2019. 

Prior to the ACA, many older adults struggled to afford coverage in the individual market because insurance companies were able to charge expensive premiums based on an individual’s age, according to the AARP. 

The ACA changed that, banning insurers from charging 50-to-64-year-olds more than three times what they charge younger, healthier policyholders. If the ACA were to be repealed, this limit would go with it and Americans over 50 could once again be subject to this “age tax.” 

Many of these older Americans also suffer from pre-existing conditions and cannot be denied coverage under the ACA. But without the ACA, insurance companies could once again discriminate against people with pre-existing conditions, including the 40 percent of adults ages 50 to 64 who live with them. 

“AARP vigorously opposes any attempt to dismantle the ACA, which will undoubtedly threaten the health and financial stability of millions of Americans, including older adults, that the law has provided for nearly a decade,” Nancy LeaMond, AARP executive vice president and chief advocacy & engagement officer, said in a statement earlier this year. “Undermining the ACA will increase out-of-pocket expenses for older Americans.”

LeaMond also cited the potential return of the “age tax” in the organization’s opposition to ACA repeal.

Republicans, including Arizona’s own Sen. Martha McSally (R-Ariz.), nearly repealed and replaced the ACA in 2017, an outcome that would have allowed insurers to charge people over 50 five times more than younger customers. If they had been successful, Arizonans aged 55 to 64 would have seen their out-of-pocket costs increase by as much as $19,566 per year by 2026, according to an estimate from the left-leaning Center for American Progress.

McSally’s office did not respond to a request for comment.

The CBPP report also found that 20 million Americans, including 297,000 Arizonans, will lose their insurance altogether if the ACA is repealed, while millions more will see their health insurance or health care costs rise. 

The lingering threat of ACA repeal has turned health care into a critical issue in Arizona, a state where the more than 2.3 million residents over 50 represent one-third of the state’s population, according to data from the U.S. Census Bureau.

Eighty-four percent of Arizonans said health care is a “top” or “important” priority, according to an August 2019 poll from Public Policy Polling. The poll is particularly skewed towards older Arizonans’ concerns, as 45 percent of the 680 respondents were between the ages of 46 and 65.

The stakes could hardly be higher for those Arizonans and millions of other Americans, according to the AARP.

“The ACA is deeply rooted into the nation’s health care system and economy. Millions of Americans depend on the Act for their health, protection and wellbeing,” the group said in its amicus brief. “Their lives now hang in the balance.”