
Nine years after the Affordable Care Act (ACA) was signed into law, there is much to celebrate regarding the progress made in American health care. The uninsured rate has been cut in half, insurers can no longer deny, drop, or limit the care you get because of a pre-existing condition, out-of-pocket spending has dropped by double digits, millions of people benefit from tax credits to pay for coverage or no-cost preventive care, women can no longer be charged more than men, and millions of young adults can stay on their parents’ plan until age 26.
It’s no surprise, then, that the ACA is more popular today than ever. The relentless threats from Republican lawmakers in recent years to repeal the ACA and reverse these gains drove millions of Americans to the polls this past November, where they overwhelmingly voted for candidates that support keeping and strengthening the ACA rather than attempting to sabotage it. However, the message they sent loud and clear to Congress seems to have been ignored.
Last year, Republican officials in 20 states took to the courts again to challenge the ACA, suing the federal government to repeal the law in its entirety. In an unprecedented dereliction of duty, the Trump Administration’s Department of Justice refused to defend the law of the land in court, and in December the judge ruled the ACA unconstitutional. If the ruling is not overturned, it will undo the entire ACA, ripping coverage from millions of Americans, raising costs, ending protections for people with pre-existing conditions, and putting insurance companies back in charge.
On the day of the ruling, President Trump then nominated to the Sixth Circuit Court of Appeals the very same Department of Justice official who actually filed the Trump Administration’s brief in support of Texas v. United States, Chad Readler. Readler’s nomination and recent party-line confirmation vote – supported by Senator Joni Ernst – signals the Trump administration and Senate Republicans’ intent to continue their attacks on health care through the judicial system.
Though Senator Ernst claims that she supports maintaining protections for people with pre-existing conditions and other popular provisions of the ACA, time and again she has failed to keep her promise and stand up for Iowans. In total, Senator Ernst has voted seven times to repeal the ACA and all the protections it offers for Iowans.
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As these numerous threats to health care continue, the stakes could not be higher for Iowans. Since the ACA was enacted, 132,000 Iowans have gained health care coverage, slashing out state’s uninsured rate by more than four percent. 24,000 young Iowans were able to maintain or gain coverage by staying on their parents’ plan, and 143,400 Iowans gained coverage through Medicaid expansion. And, perhaps most notably, the 1,288,400 Iowans living with a pre-existing condition can no longer be discriminated against, denied coverage, or charged more because of their medical history.
Nine years ago, the ACA was signed into law. Seven years ago, the Supreme Court upheld it. Two years ago, Congress failed to repeal it. Mere months ago, voters expressed overwhelming support for it at the ballot box. But from the Texas v. United States lawsuit to eliminate the ACA, to the budget recently proposed by the Trump administration that slashes Medicaid and Medicare, the war on health care persists. As we recognize the anniversary of the ACA, we must continue speaking out against the threats to our health care, holding elected officials like Sen. Ernst accountable, and demanding that they protect our care.
by Representative Timi Brown-Powers
Photo by Julie Fleming
State Rep. Timi Brown-Powers is a member of the House Human Resources Committee and serves in House District 61. She is a therapist at Covenant Medical Center in Waterloo.

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