The Supreme Court has heard arguments in a case that could spell the end of Obamacare, the health care law that Republicans have been seeking to overturn for more than a decade.
But while it's impossible to predict what the justices will do, some of their comments on Tuesday suggested the Affordable Care Act, or ACA, may survive.
At stake is the health insurance covering close to 21 million Americans.
Here’s the latest on the battle over the ACA as well as some alternative ways to get coverage if Obamacare is indeed overturned.
Obamacare on the brink
Some court watchers had assumed Obamacare was a goner with the very recent arrival of new Justice Amy Coney Barrett, who has expanded the Supreme Court’s conservative majority to 6-3.
In a 2017 article, Barrett criticized a previous ruling that saved Obamacare. But during her confirmation hearings last month, she said, "I’m not here on a mission to destroy the affordable Care Act."
Chief Justice John Roberts said on Tuesday that killing off the health care law is no task for the nation's highest court. He said repeal is a matter for Congress.
"I think, frankly, that they wanted the court to do that, but that's not our job," Roberts said.
At issue is the "individual mandate," the portion of the law that required Americans to carry health insurance or pay a penalty.
In 2017, a Republican-controlled Congress eliminated the penalty. Obamacare opponents have said that without the penalty, the law should be struck down.
Justice Brett Kavanaugh suggested that would be going too far. "It does seem fairly clear that the proper remedy would be to sever the mandate provision and leave the rest of the law in place," he said during the oral arguments.
The future of health care in the US
The new case comes as many Americans have lost their job-based health coverage due to the coronavirus pandemic and recession, and after a presidential campaign that laid out very different visions for the future of American health care.
President Donald Trump suggested Joe Biden’s plan would put an end to 180 million private health care plans, which the former vice president disputed.
"Not one single person with private insurance would lose their insurance under my plan,” said Biden, who's now the president-elect. “Health care is not a privilege, it’s a right."
Biden wants to expand the ACA. Americans could sign up for a government-run health insurance program similar to Medicare, and the current Medicare program would be permitted to bargain down prescription drug prices with pharmaceutical companies.
During his time in office, Trump has focused on driving a stake through Obamacare. He said during one of the debates that it would be replaced with "a brand new, beautiful health care" plan, though he offered no details.
What to do if Obamacare is repealed
Veteran reporters who cover the Supreme Court say it's foolish to make guesses on how the court will rule based on comments made in the oral arguments.
So, the Affordable Care Act might still be struck down, and millions of Americans would need to find new health insurance. The law ensures no one can be denied coverage and restricts the kind of information insurers can use when deciding what to charge people.
The court's decision may not arrive until June of next year. So, if you’re currently covered under Obamacare it would be wise to start making plans now in case you lose your health insurance.
Here are a few options to consider:
Join your spouse's or domestic partner’s plan
If you rely on the ACA, you probably don’t have the option of getting health insurance coverage through an employer.
But if your spouse or domestic partner currently has coverage through work, you may be able to sign up for their health care plan.
Ask your significant other to look into the steps involved in joining the company plan, and gather all the required documentation ahead of time if possible. That way you’ll be prepared to make the transition immediately if Obamacare ends.
Sign up for a health sharing plan
Health sharing plans are designed to provide inexpensive coverage to people who share common values and beliefs.
If you join a health sharing plan, you’ll be required to send in a monthly "share" that will be distributed among the other members of the plan who have medical expenses.
It’s important to note that many of these plans are run by religious organizations, and you may be required to make a statement of faith in order to qualify. Additionally, certain health care expenses related to smoking, drinking and birth control may not be covered.
Purchase private coverage
Buying private coverage outside of your state’s health insurance marketplace is another option and could potentially become the norm for Americans if the ACA goes away.
To find the lowest rate on a private policy, it’s wise to spend some time shopping around and comparing quotes from multiple insurance companies.
You can use an insurance comparison site that will sort through hundreds of offers to find you the best rates available in your area. Comparing rates online is free and takes only a few minutes.
Other ways you can prepare
It’s essential to have a backup plan for coverage, but you may need to take some additional steps to ensure your new solution works.
Start putting some money into an emergency fund if you don’t already have one set up. Emergency savings can help offset the cost of any unexpected medical expenses as well as the potential increase to your premium that may result from switching coverage.
Plus, if you stash your emergency fund in a high-yield savings account, it will collect a solid amount of interest and grow — giving you more money down the road when you need it.
The next step is to examine your retirement plans, since repealing the ACA would eliminate a number of free services currently covered by Medicare, and force seniors to pay more for prescription drugs.
That means Americans will need to allocate more money for medical expenses when planning for their retirement. It’s worth consulting with a certified financial planner who can help you make the adjustment or create a new, personalized strategy based on your current savings and goals.
These days, there are companies providing convenient online financial planning , so you can prepare for your future without having to leave your living room.