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An important case before the Supreme Court stands to affect the American people in a major way: Last week, the court agreed to decide a lawsuit that would eliminate health care protections for people with pre-existing conditions as part of the Affordable Care Act. If the current lower-court decision stands, millions of Americans would likely lose their health coverage and millions more would likely be adversely affected.

The case is the result of a 2018 Republican state-led lawsuit that invalidated the ACA’s coverage for people with pre-existing conditions. Twenty mainly Democratic states are suing to keep the law intact.

“There could be essentially total chaos,” said Cynthia Cox, director for the Program on the Affordable Care Act at the Kaiser Family Foundation. “There’s no replacement plan that is ready to go and so essentially what would happen next is possibly over a short period of time, or possibly immediately, we would start seeing the ACA being unwound. And the immediate effect would be that literally tens of millions of people could lose coverage and also even more people could have other changes to their coverage.”

President Trump promises, while campaigning, to protect people with pre-existing conditions, but neither he nor his fellow Republicans have offered a plan for doing so.

This is the same president who promised to protect Social Security, Medicare and Medicaid, yet has put forth a 2020 budget that cuts trillions from their allocations. There’s simply no reason to believe he’ll protect Americans with pre-existing conditions — especially while his party has sued to eliminate protections.

The truth is that, unable to outright eliminate the ACA, Republicans have been chipping away at its provisions for years: reducing the time frame for applying for coverage, refusing to reimburse insurers for lower-income customer discounts and now eliminating the individual mandate. In 2018, the number of Americans with health insurance dropped for the first time in 10 years.

And it’s not just people with pre-existing conditions who would be affected. “Tens of millions more who get their coverage through employers would also lose important benefits,” said Tara Shaw, a senior policy analyst at the Center for Budget and Policy Priorities.

The court probably will hear the case in the fall, but it’s not likely to be decided until after the election. “This case is a stark, life-and-death reminder how much is at stake this fall,” Democratic presidential candidate Joe Biden said in a statement. He’s right.

Democratic health care plans are often portrayed as radical, but other advanced nations provide comprehensive health care much less expensively with greater user satisfaction with plans that are similar to theirs. It should embarrass every American that we can’t — or won’t — accomplish what others have.

Republicans have been unable to provide any viable alternatives. At least Democrats want to point us in the right direction.

We have a saying in this state: “To be, rather than to seem.” Trump and his Republican colleagues can claim they’re protecting our health care all they want — but North Carolinians should look at what they’re doing rather than what they’re claiming.

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