Judge Reed O’Connor struck down the entire Affordable Care Act on December 14, 2018. Many lawyers believe the ruling will be reversed on appeal, however, it may land in the US Supreme Court and their ruling is not as predictable.

The changes Medicare would see if the ACA was officially struck down would be an expansion of Accountable Care Organizations. With this expansion, Medicare would pay based on outcomes of patients and not just the number of procedures they have. According to the Committee for a Responsible Federal Budget, the increase in Medicare costs if the ACA was struck down would be about $1 trillion dollars from 2018 – 2027.

In regards to Medicaid, if the ACA was struck down, it would become increasingly difficult for senior patients and young people with disabilities to receive in-home care. Specifically looking at older patients who are 50 – 64, certain provisions that the ACA contained may drastically change. One being the premiums seniors pay for insurance.

Before the ACA was enacted, seniors would pay premiums that were 11 times higher than younger buyers. After the ACA was enacted, they only allowed the premium to be a max of 3 times higher than that of younger buyers.

Other provisions that may be affected include “minimum benefit requirements” and “the ban on insurance companies rejecting potential purchasers due to pre-existing conditions.”