Apache and Navajo counties averted a potential health care disaster this week when the new conservative majority on the US Supreme Court sidestepped the latest Republican effort to overturn the Affordable Care Act.
The high court ruled that Texas, Arizona and a handful of other Republican states had no standing to seek the overturn of the 2010 federal law.
In Arizona, the law extended coverage to about 140,000 residents through the federal insurance exchanges and another 600,000 residents by expanding coverage by the Arizona Health Care Cost Containment Act.
Nationally, it reduced the number of people without insurance by 70%.
The Biden administration has now opened an extra window for people to apply for coverage and increased the share of people who can get their premiums subsidized.
People making up to $51,000 can now get free coverage, due to money included in the American Rescue Plan.
The administration hopes to make the expanded subsidies permanent.
The expansion covers premiums for individuals and families making up to 400% of a federal poverty level wage.
Half of the people now applying for coverage of a mid-level plan on healthcare.gov can probably get coverage for $10 a month or less, according to the US Centers for Medicare and Medicaid Services.
An estimated 25% of those already on a plan can probably reduce their premiums substantially.
The administration has also resumed marketing the Affordable Care Act plans, hoping to reverse a three-year slide in enrollments that has seen the share of the population without medical insurance inch upward to about 11%.
The administration has announced plans to shore up the ACA and add a public option to the array of private plans people can buy through Healthcare.gov, the online portal through which people can sign up for coverage.
President Biden’s so far resisting calls from the progressives in the Democratic Party to simply make some version of Medicare for retirees available to the entire population — essentially replacing employer provided health care plans.
The US currently remains the only advanced industrialized country without universal health care, even though we spend two or three times as much per capita on healthcare.
Most Republicans have supported efforts to repeal the ACA and have strongly opposed efforts to expand coverage or add a public option.
In Navajo County, 54% of residents rely on AHCCCS.
The 59,000 people enrolled in June represents a 7% increase in the past year.
In Apache County, 56% rely on AHCCCS. The 40,000 people enrolled have increased by 5% in the past year.
Children account for about 40% of the people covered by AHCCCS, the impoverished elderly in nursing homes for about 3% and the seriously mentally ill for another 3%.
Single mothers also account for a large share of the covered population.
Some observers had predicted the new conservative majority on the Supreme Court would uphold two lower-court rulings that would have essentially overturned the law.
The Supreme Court had earlier ruled that an ACA provision that fined people who didn’t have health insurance was unconstitutional.
A coalition of Republican-led states including Arizona then filed a new lawsuit, saying that the elimination of the individual mandate made the entire law unconstitutional.
If the court had overturned the law, an estimated 21 million people would have lost their healthcare, according to the Urban Institute.
That includes young adults allowed to remain on their parents plan until the age of 26.
It would have also overturned provisions requiring all insurance plans to cover “preexisting conditions” without charging higher rates for individuals.
However, the US Supreme Court this week ruled that the Republican states weren’t harmed by passage of the law – and therefore did not have the legal standing to challenge it.
The justices didn’t actually rule on the underlying legal argument made by Arizona Attorney General Mark Brnovich and others.
Brnovich is now running for the US Senate, which could give him another chance to vote in the senate to repeal the act.
The court did not rule on the underlying claims that the law is unconstitutional, but legal experts say the law now appears more secure than at any time since its passage a decade ago.