The recent death of Justice Ruth Bader Ginsburg and President Trump’s promise to replace her in the Supreme Court as soon as possible have increased the possibility that the Affordable Care Act could be overturned amid a pandemic.

We spoke with Abby Goodnough, our health care professional at The Times, about the possible consequences of repealing part or all of the law.

cover: Approximately 21 million Americans are at serious risk of losing their health insurance if the ACA is overturned. Millions of Americans have already lost their work-related health insurance during the current crisis, and many have relied on Obamacare for replacement insurance. “It was a huge safety net,” Abby said. “The last thing you want is to get the coronavirus and then not have insurance coverage for the really expensive medical care that comes with it. And many people are already faced with it. “While there are temporary provisions designed to help Americans pay for coronavirus-related medical expenses, funding for these programs is limited.

Vaccinations: The ACA contains a mandate for insurers to provide coverage, much of it free, and that includes vaccines. If effective coronavirus vaccines arrive, we expect they will be free based on a provision in the ACA, Abby said.

Preconditions: Obamacare prevents insurers from refusing to cover people with pre-existing health conditions. Contagion with the coronavirus, which affects many patients with persistent health problems, could make it difficult or impossible for people to get health insurance in the future if part or all of the ACA becomes invalid.

Hospitals: The ACA has strengthened the financial health of many hospitals, including by expanding Medicaid to cover poor Americans. When Medicaid recipients travel to the hospital, the hospitals are reimbursed for a portion of the cost, while they may not have received anything in the past.

Basic health: Many studies have shown Obamacare generally contributed to overall health outcomes. Ensuring preventive treatment could help stave off chronic conditions like obesity and diabetes, which increase the chances of someone getting seriously ill with the virus.

Parents – and even children – may want to prepare for this before reading: Adults may be able to get a coronavirus vaccine by next summer. But children have to wait longer. Maybe much longer.

While a number of adult vaccines are in advanced clinical trials, there are currently no trials for children in the United States.

“Right now I’m pretty concerned that we won’t have a vaccine available for children by the beginning of the next school year,” said Dr. Evan Anderson, Pediatrician at Children’s Healthcare in Atlanta and Professor at Emory University School of Atlanta Medicine.

Children’s vaccine needs are different from adults. The pediatric immune system can respond differently to a vaccine, and even children of different ages can respond differently. And because children are less likely to get Covid-19, the bar is particularly high to ensure that there are no adverse side effects.

Whenever pediatric studies begin, vaccines can take a year or more to become available to the public. That extends the time to the latter half of next year, said Carl Zimmer, who covered the story for The Times. “If children are vaccinated by fall 2021 and rates are low in their community, you can imagine living normally again,” he told us. “But if the rates are still high and the vaccines aren’t ready until the spring of 2022, all of the things we are now grappling with with kids at school will continue in a year.”

His takeaway food? “Everyone has to prepare for a long winter.”

Here is a summary of the restrictions in all 50 states.

  • In their speeches to the United Nations Annual General Assembly, the Presidents of the United States and China discussed the coronavirus, global warming, human rights, international cooperation and a host of other topics.

  • Virtual classroom attendance is on the decline, forcing educators to make difficult decisions about distance learning.

  • A committee advising the Centers for Disease Control and Prevention has postponed the vote on plans to introduce vaccines.

  • Congress gave the Pentagon $ 1 billion to build the country’s medical equipment inventory, but most of the money was channeled to defense companies that made things like engine parts, body armor, and uniforms, the Washington Post reports.

  • An Iowa school district that had openly defied the Republican governor of the state by teaching remotely decided to upgrade to a hybrid model next month.

  • A new study found that colleges and universities that reopened for face-to-face teaching were fueling an additional 3,200 cases per day, reports the Wall Street Journal.

  • Three NFL coaches and their teams face a fine of over $ 1 million for going maskless during games.

I try to focus on the choice. I write postcards to voters in other states and hope that thousands of others will do the same so that we can have a record turnout in November.

– Alexa Sorock, Evanston, Ill.

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