The Trump administration is supporting a lawsuit which seeks to overturn the Affordable Care Act (ACA) in its entirety. The implication is that a large share of the older workers now able to afford health insurance as a result of the ACA will no longer be able to afford it if the Trump administration wins its lawsuit.

Furthermore, if the suit succeeds it will both end the expansion of Medicaid, which has insured tens of millions of people, and again allow discrimination against people with serious health conditions. Ending this discrimination was one of the major goals of the ACA. The issue is that insurers don’t want to insure people who are likely to have health issues that cost them money. While they are happy to insure healthy people with few medical expenses, people with heart disease, diabetes, or other health conditions are a bad deal for insurers.  

Before the ACA, insurers could charge outlandish fees to cover people with health conditions, or simply refuse to insure them altogether. The ACA required insurers to cover everyone within an age bracket at the same price, regardless of their health. If the Trump administration has its way, we would go back to the world where insurers could charge people with health issues whatever they wanted, or alternatively, just deny them coverage. 

This would be bad news for anyone with a serious health condition, but it would be especially bad news for the oldest pre-Medicare age group, people between the ages of 55 and 64. This group currently faces average premiums of close to $10,000 a year per person for insurance purchased through the ACA exchanges. Insurers could easily charge people with serious health conditions two or three times this amount if the Trump administration wins its case. 

And, since a Trump victory would eliminate the ACA subsidiaries, people in this age group with health conditions could be looking to pay $20,000 to $30,000 a year for insurance, with no help from the government. That will be especially hard since many people with serious health conditions are unable to work full-time jobs, and some can’t work at all.

The 55 to 64 age group will also be hard hit because they are far more likely to have serious health issues than younger people. Just 18 percent of the people in the youngest 18 to 34 age group have a serious health condition, compared to 44 percent of those in the 55 to 64 age group, as shown in the figure above.

The ACA has many inadequacies, but it has allowed tens of millions to get insurance who could not otherwise. Donald Trump wants to take this insurance away.