These provisions were revolutionary when the ACA was passed in 2010, but have now become deeply ingrained in our health care system. Americans of all ages rightly expect that the law’s benefits will not be stripped away. That’s why Republicans had so much trouble repealing the ACA in 2017. And yet, the conservative onslaught against the law continues.

President Trump, whose administration has done everything in its power to undermine the Affordable Care Act (and refused to defend it in court), tweeted, “As I predicted all along, ObamaCare has been struck down as an UNCONSTITUTIONAL disaster! Now Congress must pass a STRONG law that provides GREAT healthcare.” Of course, that’s what Trump demanded before the disastrous GOP effort to replace and replace ObamaCare. And here we are.

Though the Affordable Care Act has so far withstood Trump administration sabotage and two Supreme Court challenges, the health care system goes through unnecessary shocks every time the law is threatened — and everyday people (especially older Americans) must live in constant fear of losing coverage. If the federal judge’s decision is allowed to stand, tens of millions of Americans would lose health coverage — and the roughly 1 in 2 non-elderly Americans with pre-existing conditions might not be able to find an affordable plan.

“Near seniors” would be especially vulnerable if the law is struck down, as they are more likely than younger people to suffer from pre-existing conditions such as heart disease, cancer, and musculoskeletal problems. Near seniors also would lose another crucial ObamaCare protection: the limitations the law placed on “age rating” — the insurance company practice of charging older patients significantly higher premiums than the rest of the population, also known as the “age tax.”

If the ACA were to be struck down, millions of near seniors simply would not be able to afford health coverage. Those patients might then arrive at the doorstep of Medicare in poorer health, which undoubtedly would increase Medicare spending and raise costs for everyone.

But it is not only near seniors who would be hurt if the ACA disappears. The law included crucial improvements for Americans 65 and older who rely on Medicare. Those changes have been a boon to Medicare beneficiaries and the system as a whole. Among other things, the ACA:

  1. Effectively lowered net premiums, deductibles, and cost-sharing for Medicare beneficiaries
  2. Provided preventative care coverage — including screenings for cancer, diabetes and other chronic diseases — with no out of pocket costs.
  3. Strengthened protections for nursing home residents
  4. Improved Medicare Part D prescription benefits by closing the drug coverage “donut hole”
  5. Increased the long-term solvency of the Medicare program

For seniors living on fixed incomes, these improvements have been a game changer. More comprehensive Medicare coverage makes it more likely that retirees won’t have to choose between groceries and health care, that they can stay healthier for longer, and live with the peace of mind that the Medicare program will remain financially stronger.

Many legal experts and ACA advocates are confident that the federal judge’s shoddily reasoned ruling striking down the law will be reversed by higher courts. Let’s hope that reason and justice prevail, given everything that’s at stake. As California Attorney General Xavier Becerra, one of the Democratic state officials challenging the judge’s ruling, said, “The ACA has already survived more than 70 unsuccessful repeal attempts and withstood scrutiny in the Supreme Court. [This] misguided ruling will not deter us: our coalition will continue to fight in court for the health and wellbeing of all Americans.”

Max Richtman is president and CEO of the National Committee to Preserve Social Security and Medicare, a membership organization that promotes the financial security, health and well being of current and future generations of maturing Americans. He also chairs the board of the National Committee’s PAC.

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