# Opinion: Americans are just one Supreme Court decision away from even higher drug prices

The potential winners and losers if the ACA is overturned are clear, especially when it comes to access to affordable prescriptions.

The winners? Drug companies that control the production and flow of prescription medicines for all Americans, raising prices any time they want, and putting our health at risk to keep boosting their profits. 

The losers? Americans, especially older Americans, who already pay more for prescription medicines than any comparable nation in the world. They will pay more or be denied access altogether if the ACA is overturned.

President Donald Trump and Republicans in Congress spent most of the past four years trying to repeal, dismantle and weaken the Affordable Care Act in addition to attacking Medicaid and Medicare, the public insurance programs Americans depend on most.

Before the ACA, insurers could refuse to cover prescription drugs and other essential services. The ACA made coverage of prescription medicines an essential health benefit for all ACA plans. The law also made some prescription medicines that are commonly used for preventive care like vaccines, available with no out-of-pocket cost to everyone with private insurance and seniors on Medicare.

For years, many seniors with Part D had to pay 100% out of pocket for their medicines because of the “donut hole” coverage gap. The Affordable Care Act ended this loophole, providing millions of seniors  on Medicare lower prices on prescription drugs. Closing the “donut hole” has saved more than 11.8 million Medicare beneficiaries over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary, between 2010 and 2016, according to the Center for Medicare and Medicaid Services.  

The price of prescription drugs — for seniors and everyone else — is rising faster than the price of any other medical good or service. In 2020 alone, Big Pharma has raised the price of 2,519 medicines, a majority of which had no generic alternative for patients to fall back on — and in the middle of a pandemic.

Repealing the Affordable Care Act would be a major win for prescription drug corporations which could expect an additional $2.8 billion in annual tax breaks on top of the multi-billion dollar tax cut Trump gifted them in 2017. Meanwhile, seniors and every other American in need of affordable medicines would face increasingly higher drug costs.

Whether you get your prescriptions through health care coverage from the ACA exchanges, expanded Medicaid, Medicare, or private insurance: the Court’s upcoming decision will leave no American untouched. The Supreme Court striking down the ACA could eliminate healthcare for over 20 million people and end protections for 135 million people with pre-existing conditions including high blood pressure, arthritis, diabetes and cancer. 

Read: This is what it could cost you if Obamacare is thrown out by the Supreme Court

Repeal of the ACA could mean much higher prescription drug prices for millions of Americans — for  grandparents that need insulin, children that need Epi-pens for asthma inhalers and adults that need cutting edge cancer treatments. 

The voters have spoken and rejected Trump’s anti-healthcare policies, but the legacy of Trump’s attacks remain. Pharmaceutical corporations continue to prove that our health is not their priority. If the Affordable Care Act is overturned, millions of Americans will be left at their mercy. 

Richard Fiesta is executive director of the Alliance for Retired Americans, a founding partner of Lower Drug Prices Now.

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