Washington – Now that the fight over Obamacare is history, perhaps everyone can finally focus on making the program work the way it was designed. Or, preferably, better.
The fight is history, you realize. Done. Finito. Yesterday’s news.
Any existential threat to the Affordable Care Act ended with the popping of champagne corks as the new year arrived. That was when an estimated 6 million uninsured Americans received coverage through expanded Medicaid eligibility or the federal and state health insurance exchanges. Obamacare is now a fait accompli; nobody is going to take this coverage away.
There may be more huffing, puffing and symbolic attempts at repeal by Republicans in Congress. There may be continued resistance and sabotage by Republican governors and GOP-controlled state legislatures. But the whole context has changed.
Now, officials in states that refused to participate in Medicaid expansion will have to explain why so many of their constituents — about 5 million nationwide — remain uninsured when they could have qualified for coverage. More than 1 million of these needlessly uninsured Americans live in Texas, which is targeted by Democrats as ripe for inroads because of its rapidly changing demographics. Will Gov. Rick Perry be forced to reconsider his Obamacare rejectionism? Or will he ultimately be remembered for speeding the state’s transition from red to blue?
Performance of the federal insurance exchange website, HealthCare.gov, will continue to improve, if only because the initial flood of applicants is bound to subside. Meanwhile, insurance costs and benefits in states that refused to set up their own exchanges will be compared with those in states that did. There will be questions about how the new law is performing — but no one will be able to pretend it does not exist.
And we will surely hear more stories about individuals taking advantage of the law’s consumer benefits, especially the fact that pre-existing conditions can no longer be used to deny coverage. This is life-changing for insurance seekers who suffer from chronic illnesses such as diabetes or have survived cancer.
Opponents of the law can hardly advocate going back to a system in which those who really need insurance can’t get it. What they can do, and surely will, is make lots of noise by pretending that any problem with anyone’s health insurance is due to the Affordable Care Act. Before Obamacare, millions of Americans had their policies canceled by the insurance companies every year. Millions more had their premiums raised, their coverage reduced, or both. Now when these things happen, critics will try to blame the new law.
Increasingly, though, the GOP will sound foolish and irrelevant if it continues to put all of its eggs in the “repeal and replace” basket. The problem is that the Affordable Care Act is a set of free-market reforms based on ideas developed in conservative think tanks. Republicans who want to repeal Obamacare would have to replace it with something suspiciously similar.
If Republicans in Congress would work with the administration to make technical corrections to the Affordable Care Act, they could claim a victory of sorts: Obama gave you this mess and we cleaned it up. But after demonizing the program — and the president — for so long, the party has painted itself into a corner.
Note to the GOP: “We refuse, under any circumstances, to make the law work better for the citizens we represent” is perhaps not the ideal campaign slogan for the midterm election.
The real problem with the ACA, and let’s be honest, is that it doesn’t go far enough. The decision to work within the existing framework of private, for-profit insurance companies meant building a tremendously complicated new system that still doesn’t quite get the job done: Even if all the states were fully participating, only about 30 million of the 48 million uninsured would be covered.
But Obamacare does establish the principle that health care is a right, not a privilege — and that this is true not just for children, the elderly and the poor but for all Americans.
Throughout the nation’s history, it has taken long, hard work to win universal recognition of what we consider our basic rights. Perhaps future legislation will expand and streamline the ACA reforms until everyone is covered. Or perhaps we’ll move toward a single-payer system, possibly by expanding Medicare and Medicaid until they meet in the middle.
I don’t know how we’ll get there, but we’re now on the road to universal health care. There’s no turning back.
Truthout Is Preparing to Meet Trump’s Agenda With Resistance at Every Turn
Dear Truthout Community,
If you feel rage, despondency, confusion and deep fear today, you are not alone. We’re feeling it too. We are heartsick. Facing down Trump’s fascist agenda, we are desperately worried about the most vulnerable people among us, including our loved ones and everyone in the Truthout community, and our minds are racing a million miles a minute to try to map out all that needs to be done.
We must give ourselves space to grieve and feel our fear, feel our rage, and keep in the forefront of our mind the stark truth that millions of real human lives are on the line. And simultaneously, we’ve got to get to work, take stock of our resources, and prepare to throw ourselves full force into the movement.
Journalism is a linchpin of that movement. Even as we are reeling, we’re summoning up all the energy we can to face down what’s coming, because we know that one of the sharpest weapons against fascism is publishing the truth.
There are many terrifying planks to the Trump agenda, and we plan to devote ourselves to reporting thoroughly on each one and, crucially, covering the movements resisting them. We also recognize that Trump is a dire threat to journalism itself, and that we must take this seriously from the outset.
Last week, the four of us sat down to have some hard but necessary conversations about Truthout under a Trump presidency. How would we defend our publication from an avalanche of far right lawsuits that seek to bankrupt us? How would we keep our reporters safe if they need to cover outbreaks of political violence, or if they are targeted by authorities? How will we urgently produce the practical analysis, tools and movement coverage that you need right now — breaking through our normal routines to meet a terrifying moment in ways that best serve you?
It will be a tough, scary four years to produce social justice-driven journalism. We need to deliver news, strategy, liberatory ideas, tools and movement-sparking solutions with a force that we never have had to before. And at the same time, we desperately need to protect our ability to do so.
We know this is such a painful moment and donations may understandably be the last thing on your mind. But we must ask for your support, which is needed in a new and urgent way.
We promise we will kick into an even higher gear to give you truthful news that cuts against the disinformation and vitriol and hate and violence. We promise to publish analyses that will serve the needs of the movements we all rely on to survive the next four years, and even build for the future. We promise to be responsive, to recognize you as members of our community with a vital stake and voice in this work.
Please dig deep if you can, but a donation of any amount will be a truly meaningful and tangible action in this cataclysmic historical moment.
We’re with you. Let’s do all we can to move forward together.
With love, rage, and solidarity,
Maya, Negin, Saima, and Ziggy