We are medical students — the next generation of physicians in America. Every day, we think about how to improve the health of our patients. Today, the greatest threat to their health is not a new virus or cancer, but the proposed legislative action of Washington politicians.
With the election of Donald Trump and a majority in both chambers of Congress, the Republican Party is poised to repeal the Affordable Care Act (ACA). Taking this step could strip 30 million individuals of their health insurance and compromise coverage for all Americans.
To us, this is unacceptable. Today’s medical students overwhelmingly share a vision for equitable, comprehensive, and accessible health care. The ACA is not a perfect law, nor is it a radical one. By providing access to healthcare for millions of previously uninsured Americans through the insurance marketplace and expansion of Medicaid; prohibiting discrimination based upon pre-existing conditions; and emphasizing preventive, quality-based care, it was a necessary first step in the right direction.
With this progress on the line, the American people and their representatives must be aware of the full consequences of a repeal. Make no mistake: for many of our current and future patients, the fate of the ACA is a matter of life and death.
Take our patient, who we’ll call Jamie Collins. He is a 52-year-old electrician, with a gruff voice that masks a soft demeanor. He has raised two sons and a daughter, who have now started their own families in North Carolina and Kentucky. Jamie’s employer doesn’t offer health insurance, and because he makes $32,000 a year, he does not qualify for state insurance through Medicaid. Before the Affordable Care Act, Jamie was uninsured. Because of the ACA, he was able to buy health insurance through the new marketplace, and he received a subsidy from the government to make it affordable. Now, we are able to treat Jamie every three months in the primary care clinic.
Jamie has long suffered from heartburn, and at our most recent visit he was having difficulty swallowing. This combination rings an alarm bell: it can mean esophageal cancer, which kills more than 80 percent of patients within five years of diagnosis. If Jamie does have cancer, the most important thing is to catch it early, before it spreads. To find out, he needs an endoscopy.
Fortunately, Jamie’s insurance will cover the test. But his fate is in the hands of legislators in Washington. If the ACA is repealed, Jamie and millions of other patients like him will be stripped of access to health care. The subsidies would end, the marketplaces would close, and Medicaid would shrink, leaving many of our patients without access to life-saving care.
We will soon begin our careers as physicians. We will be the ones practicing medicine in the health care system whose fate hangs on the upcoming fight over the ACA. In order to fully care for our patients, we have to do more than prescribe the right medicines — we have to advocate for the right laws.
That is why we feel compelled to add our voice to a conversation that has seemed to be more about partisan politics and the legacy of President Obama than about the fundamental needs of patients. We feel a moral imperative, as future doctors, to speak up for the millions of our future patients whose health is at stake.
In recent weeks, medical students around the country have rallied around the #ProtectOurPatients campaign, a national grassroots movement of health professional trainees seeking to defend the ACA and protect health care access for all Americans. Over 4,500 future medical professionals from over 150 institutions and all 50 states have signed a petition urging Congress to “do no harm” and to vote against repeal of the ACA. On January 9th, dozens of students traveled to the Capitol to stage a rally, speak with Senators and deliver the petition. In solidarity with their colleagues in D.C., 30 medical schools around the country engaged in local action.
The Republican Party, with its control of Congress and the White House, now has a critical choice to make. They have the option to continue with politics as usual, or the opportunity to move health care past the realm of partisanship. The ACA is an imperfect law, but its problems are solvable. We appeal to Congress to devote its energy toward improving and building upon the ACA, rather than tearing down the foundation it has laid. Jamie’s health will depend on the outcome, and millions of our patients -- their constituents -- will be watching their decision.
Juliana Berk-Krauss, Eamon Duffy, Samara Fox, Erik Levinsohn, Matthew Meizlish, Talia Robledo-Gil, Andi Shahu, Priscilla Wang, Karri Weisenthal