Instead of repealing the Affordable Care Act Republicans have found other ways to erode access to health care for more Americans. Policy changes, budget cuts and the elimination of programs have made it harder for moderate and low income Americans to access Medicaid, family planning services and a host of smaller programs.
These moves don’t make headlines and the people who are hurt by the changes may not even realize that they have lost something until they need a service. They also may not know that they lost coverage they may have had because they never tried to access the kind of care they had not needed.
A recent PBS report laid out some of the facts about loss of coverage, “…the Census report found an estimated 27.5 million people, 8.5% of the population, without coverage in 2018. That was an increase of 1.9 million uninsured people, or 0.5 percentage point. More people were covered by Medicare, reflecting the aging of the baby boomers. But Medicaid coverage declined. The number of uninsured children also rose, and there were more uninsured adults ages 35-64.
Though the increase in the number of uninsured Americans was modest, it could be a turning point, the first real sign that coverage gains under Obama could be at least partly reversed. This year, the number of uninsured could rise again. That’s because a previous Republican-led Congress repealed fines under the Affordable Care Act that had been intended to nudge people to sign up for coverage.”
When Obamacare was enacted there was a fine for people who did not have insurance because it was recognized that too many young and healthy people would not sign up for insurance. Unless there is a cross-section of people, both healthy and unhealthy, an insurance market cannot remain financially viable.
Knowing that they could make it look like Obamacare was failing was easy for Republicans. By cutting out more of those people who don’t use too many health care resources they could put the program in financial jeopardy. They blew up one of the supporting pillars of the program and then started proclaiming that the program was not working.
Obamacare was never a solution to the problems of the American health care non-system but it was a start. Republicans did not want to see it succeed and, despite their mean-spirited intentions, the program is still working.
Republicans also tried to eliminate the navigator piece of Obamacare. Navigators had been helping people figure out how to access the new insurance program and guide them through the enrollment process. A big chunk of funding for that program was cut and as soon as that happened enrollment took a significant drop.
It is worth noting what the PBS report had to say about the politics of health care in the battle between Washington Democrats and Republicans. “Democrats are laying the blame on Trump, long accusing his administration of deliberately undermining Obama’s health care law. House Speaker Nancy Pelosi on Tuesday blamed Trump’s “cruel health care sabotage” for the rising number of uninsured people. In a statement, the California Democrat said Trump’s ongoing efforts to erode Obama’s law have forced Americans to “live in constant fear of an accident or injury that could spell financial ruin for their families.”
They go on to note that, “Trump spent most of his first year in office unsuccessfully trying to get a Republican Congress to repeal the Affordable Care Act. He is now asking a federal appeals court to overturn it as unconstitutional. The president also slashed the program’s sign-up season ad budget and scaled back funding to help people navigate the enrollment process. Trump also removed a subsidy for insurers, thereby triggering a jump in premiums.”
Despite all of these attempts at destruction of the Affordable Care Act it remains viable. As the PBS report notes, “Yet ACA enrollment has held fairly steady, with about 20 million people covered by its mix of subsidized private plans and a Medicaid expansion for low-income individuals. The Census report found that Medicaid coverage declined by 0.7 percent from 2017.”
If we do not elect a Democrat to the White House those in power will probably feel they have a mandate to try to destroy any government subsidized health care program. Then the only health care program available to vulnerable Americans will be the “Don’t Get Sick Plan”.
