How many Arizonans with pre-existing conditions will be hurt if ‘Obamacare’ is struck down?

The U.S. Supreme Court announced Monday that it will hear two cases brought by a coalition of Republican attorneys general that seek to have the Obama-era Affordable Care Act declared unconstitutional. If that happens, millions of Arizonans would be affected, a new analysis finds.

The Center for American Progress, a liberal think tank, finds that nearly 300,000 Arizonans would lose health insurance coverage entirely, and another 2.8 million with pre-existing conditions would face higher premiums, diminished coverage or an inability to buy insurance on the open market if the lawsuits succeed.

Arizona Attorney General Mark Brnovich is one of the attorneys leading the lawsuit.

The CAP analysis also finds that Arizona would lose $2.1 billion in federal health care funding. That money funds the private insurance marketplace, Arizona’s Medicaid program and health insurance for children in poor families.

Nationally, nearly 20 million people would lose their insurance and 135 million with pre-existing conditions would face higher costs or the inability to get insurance.

The legal arguments in the case center on the 2017 tax law that reduces the amount of the tax collected on Americans who don’t purchase health insurance to zero. Brnovich and the other attorneys general have claimed that it is unconstitutional for the mandate to collect no tax revenue – and that, as a result, the entire Affordable Care Act is also unconstitutional.

Among the provisions of the federal health care law is that insurance companies can’t deny coverage or charge more to people who have pre-existing conditions. The law also provided billions of dollars to expand Medicaid coverage – done in Arizona by the Arizona Health Care Cost Containment System, or AHCCCS – and to provide health insurance to children in low-income homes.

Legal scholars – even those who have sought to persuade the courts to overturn the health care law – largely view the arguments as unlikely to win. As Vox reported:

The Republican legal arguments against Obamacare in this case are widely viewed as ridiculous, even by many lawyers and scholars who spent much of the last decade trying to convince the courts to repeal President Obama’s signature achievement.

Jonathan Adler, a conservative law professor — and a leading evangelist for an earlier lawsuit seeking to undercut the Affordable Care Act by reading a poorly drafted provision of the law to cut off much of the act’s funding — labeled many of the red states’ arguments “implausible,” “hard to justify,” and “surprisingly weak.” The Wall Street Journal’s editorial board labeled this lawsuit the “Texas Obamacare Blunder.” Yuval Levin, a prominent conservative policy wonk, wrote in the National Review that the Texas lawsuit “doesn’t even merit being called silly. It’s ridiculous.”

Arizona legislators have sought to get out in front of the lawsuit, at Brnovich’s request, and ensure that some coverage of pre-existing conditions will remain in Arizona law if the federal law is struck down.

However, the proposal that Arizona Republicans are pushing would only require insurance companies to provide coverage for pre-existing conditions. It wouldn’t prevent them from charging higher rates to those estimated 2.8 million Arizonans, and it wouldn’t mandate other Affordable Care Act provisions like ending lifetime caps on insurance coverage or requiring coverage of things like emergency services, prescriptions and maternity care.