Americans’ health at stake: Georgia Senate run-offs decide future

How many more Americans die from COVID-19 may hinge on the results of Georgia’s Jan. 5 Senate run-off elections. In the midst of a raging pandemic, health coverage for millions and protections for those with preexisting conditions could disappear. 

As professors of health law and policy with over two decades of combined experience, our research and knowledge of law and legislative history can break down what is really at stake. 

The American health care system is undeniably in crisis. With more than 200,000 new COVID-19 cases per day in America and record-shattering daily deaths — at least 3,054 in one recent day — hospitals nationally are already overwhelmed.  

Even before the expected winter pandemic spike, Jackson, Miss., has no Intensive Care Unit (ICU) beds left and the regions around Athens and Valdosta, Ga., report just two ICU beds remaining. 

An estimated 4.7 million people have become permanently unemployed because of the pandemic, many of whom have lost their job-based health insurance coverage already during the pandemic; nearly 30 million were already uninsured when it hit in March of this year. One in seven Americans say they would avoid seeking care for COVID-19 over fear of the cost. 

In these upcoming elections, Georgians will decide whether Congress will be divided, with Democrats controlling the House and Republicans controlling the Senate, or whether the Democrats will control both chambers. 

Divided government can be a good thing. But a divided Congress in the middle of a pandemic may be lethal. 

Only Congress has the power to provide economic relief to families and businesses so that people can stay home, and stay safe. Yes, vaccines are on the way and may begin to be distributed as soon as later this month. But many won’t survive the dark winter before vaccines restore normality. 

To save lives, Congress has to pass a stimulus plan to pay businesses and restaurants to shutter for a time, to provide personal protective equipment (PPE) to our health care workers and to extend unemployment for those out of work. It will also take a functioning Congress to fund national distribution of the vaccine. 

An even worse scenario is if the Supreme Court of the United States strikes down the Affordable Care Act (ACA) and a divided Congress cannot agree on a replacement. This result is not far-fetched. 

In November, the Supreme Court heard oral arguments in a case arguing for exactly that result — for the entirety of the ACA to be deemed unconstitutional. Though conservative scholars agree that the case to strike down the ACA is weak, Justice Amy Coney Barrett’s recent Supreme Court confirmation makes its demise suddenly more plausible.

Congress could save the ACA with one sentence, but division would make it unlikely. 

If the ACA is struck down, the immediate consequences are dire. Nationally, more than 21 million people, including 581,000 Georgians, would lose the health insurance coverage they gained under the ACA. 

Protections for people with preexisting conditions — public support for which is higher than ever — would disappear. Even before the pandemic, over 4 million Georgians had preexisting conditions that could make them uninsurable without these protections. 

COVID-19 and the potential long term consequences that come with it mean that number is now even higher. Insurers would once again be able to cap annual or lifetime benefits, cutting off coverage for those with cancer or expensive chronic conditions. Health plans would no longer be required to cover the 74,000 young adults in Georgia who stay on their parents’ plan until age 26.  

Some may worry that a Biden-Harris administration with control of both chambers of Congress would radically change health care in America. But President-elect Joe Biden’s health care plan is far from radical. He wants to give people an option to purchase coverage like Medicare, to increase funding for individuals to purchase their own policies and to lower the age of Medicare eligibility to 60. But even these small, incremental fixes require legislative action that would be dead on arrival if Republicans control the Senate. 

Meanwhile, if Congress is paralyzed, it is not realistic to think that states can tackle the health care crisis alone without congressional funding. Before Congress got involved and passed the ACA in 2010, millions of sick people couldn’t get coverage at all. 

With the health and economic crises that COVID-19 has wrought, Americans are counting on Congress to act to ease their suffering. Georgia’s two Senate run-off races will decide whether Congress will be able to pass a desperately needed stimulus, to save the ACA if the Supreme Court strikes it down and to make incremental improvements to it that would help more Americans access health care during the most dire of times. 

Too many Americans are sick and dying. Now is the time to unify Congress to avoid gridlock and save lives. That process can begin in Georgia. 

Wendy Epstein is professor of Law and the faculty director of the Mary and Michael Jaharis Health Law Institute at DePaul University. She is a Public Voices fellow of The OpEd Project. 

Erin Fuse Brown is associate professor and the director of the Center for Law, Health & Society at Georgia State University College of Law.