It has been months since I last scribed about the Patient Protection and Affordable Care Act, otherwise known as the Affordable Care Act (ACA), colloquially referred to as, “Obamacare.”
Before my last post, I wrote vociferously about the need for health care that all Americans could access and afford, most notably in the pages of this publication, but also elsewhere: “The Critics Prove Obamacare is Right for the Nation,” and “Legal Rx.: Healthcare As A Right in the Age of Obamacare.”
I was also called upon to advise and counsel Members of Congress, most notably from my home state of Illinois, on the merits of the ACA as it was being developed. After all, I am one of the “old timers” in health care law, first setting out to become an expert in the area 44 years ago, including a look at health policy issues starting about 30 years ago.
When the ACA was passed and all legal challenges to it concluded, I thought it was time to retire my pen on this topic. Because I have been proven sorely wrong, the need and reason for this post should be most apparent.
But this writing is not about me. It’s about maintaining in previously published pieces that health care is a right for all Americans, not in a constitutional sort of way, but as a moral imperative, long before Bernie Sanders said it on the campaign trail last year, or Barack Obama saying it as part of his campaign when debating John McCain in Nashville, Tennessee in 2008 (saying health care is a right, not a privilege or responsibility), or even before Teddy Kennedy mouthed the idea at the 2008 convention.
Even a U.N. resolution going back nearly 70 years ago advanced health care as something to be provided for a nation’s citizens. As we have seen in developed countries worldwide, health care is so sacred and fundamental a right to some nations that they provide it for their citizens.
Just look at journalist and reporter T.R. Reid with the contents of his book, The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care, chronicling his travels to various countries, looking into their health care systems in comparison to ours.
But for the United States ― and after Reid had his book published ― we still have an incredibly hard time accepting this idea. Witness as late as last night with Trump’s words on repealing and replacing Obamacare before a joint session of Congress.
But what ACA has done is provide millions of Americans with the ability to access and acquire health care insurance that they could never have hoped to acquire before the ACA became law seven years ago to this month. And that is more significant than any Republican mouthing the words, “repeal and replace,” or Trump believing that Obamacare is “disastrous.”
To this, the word “bunk” seems most apropos... though Obama failed to have included the Public Option in it (think universal health care a la Bernie Sanders) because Republican industry backers thought it would provide too much competition for insurers and would lower premium prices way too much when their profits were factored in.
Yet, still, Trump knows as much about health care and what goes into providing it to save the lives of millions of Americans as this writer knows about building a jet aircraft (remember him saying the other day how complex health care is, but those of us in the know have known that for years, which is what led up to creating and writing the ACA).
Let’s get back to addressing the title of this post.
Yesterday, Texas Republican U.S. Senator, John Cornyn, stated on cable news that Obamacare had to go because that is what Trump promised his supporters on the campaign trail. Translated, Obamacare must go regardless of whether millions of American lives will suffer if they cannot access and afford health care insurance provided through the ACA. Thus, Republicans want to vanquish Obamacare not because it does not provide enough benefits, is too costly, does not address why providing health care in the U.S. is overpriced, or came about through the efforts and leadership of the country’s first Black president, but because Trump promised a minority of voters this last election cycle that it would fall.
This is the real reason Republicans want to see the ACA become history. One must ask the question: Should politics trump (excuse the pun) the ability to maintain health, acquire health or re-acquire health? After all, that is what the ACA provides. If the recent town hall gatherings are any indication, buyer’s remorse from November 8 has set it so the resounding and deafening answer is, “NO!”
Keep in mind, even for Trump voters, without health, nee health care, how can one be productive individually to one’s family, to one’s employer, one’s community, or even to the country as a whole? If we don’t have health, we don’t have much of anything, right?
Trump in his teleprompter speech last evening spoke of a new health plan that will be the best ever. Hardly, since benefits found in the ACA must be paid for, and the mechanism for doing that (called the individual mandate) is what insurers required if they were mandated by the law to cover, for instance, pre-existing conditions, or having no caps on limits, or covering children on their parents’ policies until age 26.
Trump then spoke about health savings accounts, credits, even purchasing insurance across state lines that provide a better alternative than ACA. Chest pounding without substance like Trump does constantly is not the answer. His mention of these alternatives won’t lower premium costs and they certainly won’t guarantee the benefits Americans now enjoy with Obamacare!
As to purchasing insurance beyond a state’s border, the ACA already provides that option; insurers, however, are not in favor of writing such policies because of its obstacles, like what physicians would be in network and out of network, and under what regulating authority would such companies offering these policies be governed?
After all, states typically regulate insurers operating within their borders, so which state would control an insurer in, let’s say, Montana that insures a policyholder in Mississippi? In the end, any alternative placed on the table by Republicans cannot achieve the same benefits provided by the ACA with lowering its costs. It cannot be done ― Trump’s bluster notwithstanding, and his even saying he will ensure better benefits at lower prices! Another of his cons. And… we mustn’t forget that insurers still need to make a profit for the risks undertaken and benefits provided. Complicated indeed.
In the end, the ACA needs tweaking no doubt, as every major piece of legislation always does; just look at Medicare passed in 1965. But the ACA does not need to be repealed and replaced, because the structure of it enables millions of Americans to afford and access health care insurance for their health like never before. It is consequently the vessel that provides all citizens with a right to health care, a minority of voters electing Trump notwithstanding.
Have you or your family benefited from the Affordable Care Act? If you’d like to share your story on HuffPost, email us at ACAstories@huffingtonpost.com.