The Affordable Care Act (ACA), passed by President Obama and Congress more than a decade ago, is an indispensable piece of policy, not only providing the care Ohioans need, but supporting one of the most critical industries in our economy.

With over 210,000 Americans dead--including almost 5,000 Ohioans--and almost 28 million out of work, we are still fighting to protect peoples’ health care. The president’s Supreme Court nominee opposes the ACA and the Republican-led Senate is barreling toward a rapid confirmation. A lawsuit to dismantle the ACA – supported by the Trump Administration - awaits her arrival on the bench. It could cause roughly 23 million people to lose coverage and eliminate essential consumer protections, including those for people with preexisting conditions; requirements for insurers to spend premium dollars on patient care; and mandates that insurers cover prescription drugs, mental health care, and other essential health benefits.

The ACA supports good Ohio jobs

If health is the first wealth, then the ACA has done more to build wealth in Ohio than any public policy in 50 years – possibly more. The ACA expands health care access to about 857,000 Ohioans, easing financial stress from medical debt, restoring health and enabling self-sufficiency for hundreds of thousands. Today, 196,806 Ohioans have health insurance through the ACA’s federal marketplace, which helps families earning up to four times the poverty level, and 660,345 have health coverage through the ACA’s Medicaid expansion to cover working people living just above the poverty line, as well as people with disabilities and caregivers.

Economic modeling commissioned by Policy Matters Ohio found the $4 billion federal funds the Medicaid expansion injects into the Ohio economy not only provides health care for hundreds of thousands but supports 54,000 jobs across all sectors, from expanded construction and new demand for goods and services to direct health care in hospitals and doctors’ offices. These jobs are not concentrated in big cities or specific regions; they are spread across every county and community in the state. We tracked how the increased private sector health care jobs in places like Jefferson County helped replace income lost when manufacturing plants closed and good jobs were lost in the recession of 2008.

Overturning the ACA would make Ohioans sicker and cost many people jobs. The damage would extend to thousands of communities, businesses and families across the state. It would endanger health care systems in rural areas and could devastate hospitals that serve low-income communities in metropolitan areas.

The ACA makes life in Ohio more fair

The ACA helps correct some part of our unjust economy. Since it took effect in 2010, the ACA increased insurance coverage among all racial groups, but particularly among Black, Asian, Native American and Latinx Americans, according to The Kaiser Family Foundation. But as soon as President Trump took office, he tried to scrap the ACA. When that didn’t work, he and his allies found other ways to attack it, such as cutting funding for the navigator program that helps people sign up for a plan over the ACA marketplace. Uninsured rates began creeping back up. Despite the gains, white people are still more likely to have coverage than people of color. Too often Black and Latinx families are afflicted with poverty, stress and over-exposure to pollution, weakening health. A truly antiracist health policy agenda would dismantle all these barriers as well. But in the United States, health insurance is often contingent upon employment. In a pandemic recession with millions out of work and losing coverage, the ACA saves lives.

The ACA makes Ohio healthier

The ACA shows the power of good public policy to measurably improve people’s lives. The uninsured rate has been rising but nationally, access to health care is still better than it used to be. For example, census data shows that 12.3% of Ohioans had no insurance in 2010, but that figure dropped to 6.6% in 2019. In Ohio, Medicaid expansion alone saved an estimated 1,452 lives between 2014 and 2019. Underpinning the benefits of the ACA is the Medicaid program itself, which provides health care insurance coverage to about 3 million Ohioans, a quarter the state’s population.

An increase in the federal government’s share of the state Medicaid program, from over two-thirds to about three-quarters of each Medicaid dollar, is one of the critical prongs of pandemic relief passed this year. Congress expanded Ohio’s ability to care for the 138,000 who have fallen ill to COVID-19 and at the same time, helped with the state budget shortfall, preventing even more public sector layoffs.

In Ohio, enrollment in Medicaid has increased by 7% across all categories since the recession started, jumping by 182,000 people. The increase in Medicaid enrollment is driven by an increase in the Medicaid expansion - up by 76,574 people between February and June (13.1%), almost double the rate of the overall increase – as poor working people have been laid off. They are the ones who need more federal aid, and who would suffer the most without the ACA. The urgent need for health care is evident in the huge number of people sickened by the virus, but also in the growing despair as the pandemic grinds on. The number of drug deaths in Ohio has jumped. Suicides are up.

In the “K” shaped recovery, with a rebound of wealth and employment at the higher end of the income ladder and depression-like suffering for low-income families, and a surging pandemic that has not subsided, the need for health care is growing, not shrinking.