RICHMOND, Va. (WRIC)–Virginia Attorney General Mark Herring is among those defending our nation’s healthcare system in the Supreme Court this week as the coronavirus pandemic rages on.

President-elect Joe Biden has pledged to do everything in his power to expand the Affordable Care Act–otherwise known as ‘Obamacare’–by adding a public option and maintaining private insurance. Before he can do that though, the law has to survive another challenge in a conservative Supreme Court.

If the ACA is declared unconstitutional, 642,000 Virginians could lose their health coverage, 289,081 people would have to pay more for their coverage, 109,517 seniors could see higher prescription drug prices and more than 3.4 million in the state with pre-existing conditions could lose their protections under the law, according to AG Herring’s office.

“The implications are staggering and the stakes could not be higher,” Herring said.

Suzy Szasz Palmer has seen the stakes first hand. Palmer was first diagnosed with the autoimmune disease Lupus at the age of 13. That was more than 50 years ago.

“Your body basically attacks itself,” Palmer said. “Your risk of getting an infection is higher and then the risk of complications from infections is higher.”

Palmer said she has been lucky to have reliable insurance coverage throughout her life but, as a patient advocate in Richmond, she knows several people with her diagnosis that can’t say the same. If the Supreme Court strikes down the ACA, she said those people could be denied insurance coverage or be forced to pay inflated prices because of their diagnosis.  

“So if you exclude pre-existing conditions, you’re making it very difficult for people who arguably need insurance the most to actually get it,” Palmer said.

“Mercedes and BMWs are technically ‘available’ but, if you don’t have the money to buy one and that’s the only car on the market for you, it’s basically out of reach,” she furthered.

In the current challenge before the Supreme Court, attorneys representing conservative states and President Donald Trump’s Administration are arguing that the entire ACA is unconstitutional. They claim this is the case after a Republican-led Congress repealed the tax that underpinned the law in 2017. The tax mandate required most Americans to purchase some amount of insurance to avoid a monetary penalty.

“The mandate is not really even a mandate anymore so that is one reason why we think their legal arguments are really so weak,” Herring said.

The tax mandate was unpopular among Republicans like Rep. Denver Riggleman, who was recently ousted in a re-election bid against a fellow Republican, Bob Good. Riggleman said the ACA has problems but some elements of it should stay.

Last year, he introduced a bill to sure up protections for pre-existing conditions by moving them from the ACA to the patient privacy law HIPAA but it never got anywhere. Riggleman blames both parties for refusing to safeguard this relatively popular provision before this court challenge threatened to eliminate it.

“Republicans were weak on policy and wanted to message through hyperbole on how bad the ACA was and Democrats didn’t want Republicans to have a win. That’s just how it is,” Riggleman said.

8News also reached out to Rep. Ben Cline, Rep. Rob Wittman and Rep. Morgan Griffith–the only other Republicans serving Virginia in Congress–for comment. None agreed to an interview but Griffith’s office sent the following statement on the Supreme Court case:

“Under the Constitution, the Supreme Court is charged with interpreting all laws, including Obamacare. It must be allowed to rule on the merits of the case.”

Rep. Morgan Griffith (R-VA)

University of Richmond Constitutional Law Professor Jud Campbell said, based on the oral arguments heard Tuesday, it’s ‘extremely unlikely’ that the ACA will be struck down in its entirety.

Campbell said Chief Justice John Roberts questioned if the challengers had standing to file suit in the first place and Justice Brett Kavanaugh seemed skeptical that the mandate’s removal should wipe out the whole statute. Both are historically conservative justices that will need to side with the liberals on the bench to save the ACA.

“Oral arguments are not always a perfect indication of how they’re going to vote later but the fact that they both expressed skepticism and that this is an incredibly weak legal argument says to me that the ACA is not in serious jeopardy,” Campbell said.

Campbell estimated it would take at least four months for the Supreme Court to make its final decision.