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Image via Shutterstock

The 2010 healthcare law provided tens of millions of Americans with health care and guaranteed coverage for the 135 million Americans under 65 who live with pre-existing conditions.

Thousands of Americans are dying and millions are losing their jobs and health care amid the current coronavirus outbreak. But even a global pandemic isn’t stopping Republican politicians from trying to take health care away from 20 million Americans.

A coalition of 18 Republican state attorneys general plan to move ahead with their lawsuit to strike down the Affordable Care Act, the landmark 2010 healthcare law that provided tens of millions of Americans with health care and guaranteed coverage for the 135 million Americans under 65 who live with pre-existing conditions.

The Daily Beast reached out to all 18 attorneys general to ask whether they intended to move forward with their plans to kill the Affordable Care Act. Representatives for the attorneys general of Arkansas, Georgia, Mississippi, Missouri, and Tennessee confirmed their plans had not changed. The other attorneys general offices declined to comment or did not respond.

“Thankfully the Supreme Court has found it necessary to review our case,” Arkansas Attorney General Leslie Rutlege told the Daily Beast in a statement. “Once the Affordable Care Act with its unconstitutional mandate [is] behind us, time will come for Congress to move forward and create a comprehensive healthcare law that will work with states and provide coverage for those with pre-existing conditions.”

Republicans in Congress have offered no such replacement since 2017, when they tried to repeal and replace the ACA with their own legislation. Democrats have argued that trying to repeal the ACA during a pandemic is a danger to public health. 

Xavier Becerra, the Democratic attorney general of California who is leading the defense of the ACA in court, told the Daily Beast that “no one should want to risk access to public health” in the “new reality” created by the coronavirus pandemic. 

The Republican attorneys general, led by Texas Attorney General Ken Paxton, are set to argue against the constitutionality of the ACA at the Supreme Court this fall. They’ll be pitted against 21 Democratic attorneys general, who are defending the law. Republicans’ commitment to repealing the ACA during a pandemic mirrors that of President Donald Trump, who last week said he wants to “terminate” the ACA and “have a great health care” instead. 

Under normal circumstances, repeal of the ACA would cause seismic shifts to the healthcare landscape, but in the middle of a pandemic that has infected nearly 165,000 Americans and killed 3,173 as of Tuesday morning, the damage could be even greater. 

Congress recently passed legislation guaranteeing free coronavirus tests to all Americans, but many Americans are still struggling to obtain tests amid the nationwide testing shortage. And while tests may be covered, treatment itself can be exceedingly expensive, especially if you’re uninsured. Earlier this month, an uninsured Boston-area woman was charged nearly $35,000 for her treatment, while in California, a 17-year-old boy was turned away from an urgent care because he was uninsured. The boy, who tested positive for COVID-19, later died, though his cause of death remains uncertain due to “extenuating circumstances that pointed to an alternative diagnosis as well.”

These are unlikely to be the last such stories, as there are nearly 28 million uninsured Americans, a number that is expected to rise as millions of Americans lose their jobs, and with them, their employer-sponsored health insurance.

People who received healthcare coverage through their jobs have the option of maintaining coverage through COBRA, a program that allows eligible employees and their dependents to continue receiving health insurance benefits from their employer after losing their jobs. But COBRA can cost as much as $20,000 per year for families, meaning many people will instead rely on the ACA marketplace to obtain health insurance.

Anticipating a surge in sign-ups, 11 states that operate their own health insurance exchanges are now holding special open enrollment periods for uninsured individuals. But the federal government, which runs the marketplaces for most states, has yet to implement a special open enrollment period. 

The Supreme Court isn’t expected to issue a decision in the case until at least early 2021, but with no end in sight for the pandemic, and no way of knowing how long the economic consequences could last, ACA repeal could take away the only remaining option for health care for millions of Americans.