The ACA fix (part 1)
“Death and Taxes... in this world nothing can be said to be certain, except death and taxes." Benjamin Franklin’s words are as relevant in Trump’s first year in office, as Washington’s. No One Gets Out Alive. America needs to join the civilized world and make healthcare universal, since sickness is.
Even Trump, during the GOP primary, suggested that he supported universal, single-payer coverage. But, this necessity to provide healthcare to the most vulnerable amongst us was reduced to a budget bill by congressional Republicans. Fortunately, the bill wasn’t voted on due to mass public pressure and now President Trump has asked for the Democrats to come forward with a possible plan to repair or replace the ACA. But, is there a way to repair the ACA?
Although political pundits’ predicted that a self-described socialist wouldn’t succeed politically in Middle-Americana, when independent Senator, Bernie Sanders, offered a single-payer “Medicare-for-all” solution during the 2016 DNC POTUS Primary, his popularity soared, especially with (typically healthy) millennials across all social sectors. As this young and healthy generation mature in age, and their baby-boomer grandparents expire, the entire electorate’s view of universal healthcare through a single-payer, public option will have a vast swing of popular support, similar to the rapidly changing views of gay marriage.
Clearly, the best solution is to scrap the ACA for a single-payer option, and it seems to be inevitable in time. But does that mean the ACA is unfixable? There are legitimate problems with the ACA's legislation often causing it to become practically worthless while remaining a financial liability. The Republicans are correct in saying the ACA is currently faltering and seems doomed to fail in states like Arizona.
The ACA was created with two different types of features. The first are regulations placed upon the insurers, such as not being allowed to deny coverage due to pre-existing conditions. In Obama's attempt for bipartisanship, the individual mandate was added by conservatives like Paul Ryan reasoning that those who don't carry health insurance burden the system when they have been injured, as ERs aren't allowed to turn anyone away. The idea was presented as a necessity to afford provisions like pre-existing conditions, but in reality it was the politicians (of both parties) protecting the profits of their reliable donors: the insurers. Because the individual mandate would eventually lead to universal coverage, the Democrats allowed the concession to be added. Realizing that would place unreasonable financial expectations on young adults, they added a provision to allow those under 27 to remain covered on their parents' policies.
The second feature was to create public insurance exchanges so that individuals could have the same buying power of scale-economy offered to corporate and governmental employees. This allowed people to have the choice of where they wanted to work without fear of losing healthcare and allowed millions of self-employed and under-employed Americans access to affordable healthcare. The ACA admittedly is far from the public option Americans deserve, but it was a massive relief from much of what insurers were practicing prior to 2010.
As the ACA was legislated and phased in over a period of years, the Republicans made it into a partisan affair. The ACA was branded as “socialized medicine,” a rhetoric that had served Reagan well. From 2009 – 2016 the promise to repeal “Obamacare” became the battle cry of Republicans, especially for a new class of far-right challengers calling themselves “The Tea Party.” During that time the Democrats were wiped-out, losing nearly 1,000 legislative and gubernatorial seats. While the call to repeal “Obamacare” was the successful path to many new seats for “The Tea Party,” who later united in office and rebranded themselves as “The Freedom Caucus.”
Now that they have control of all governmental branches they intend to repeal the ACA, but the sentiments are changing. Whether it's called socialism or not... people understand what is at risk: their very lives. The ACA has become too vital to repeal and now it’s time for the Democrats to show leadership, but unfortunately, much like in 2009, the deliberations have become partisan. The Democrats, not wanting to associate with repealing “Obamacare,” are gleefully hoping the Republicans mess up healthcare as they think it will benefit them in 2018 & 2020, but doing so at our expense. When it comes to offering meaningful solutions to healthcare in 2017, neither party has properly represented public interests, choosing instead protectionist positions for their political parties & donors, not their constituents.
To repeal, replace, remain, reform or repair seems to still be the essential questions when it comes to the ACA. The plan to repeal the ACA has a history that makes their prior promises their main reasoning behind the repeal motive, whereas the majority of Americans for the first time now approve of the ACA. To repeal means to take away everything that is the ACA and currently there is no political will to make constituents literally die. The idea that they can keep some of it betrays the notion of repealing, so, as of now, despite the rhetoric, there is no significant movement (besides “The Freedom Caucus”) to repeal the ACA.
The idea to replace would be great if they were offering a single-payer public option as the replacement, however the only Republican that seems interested in that is.... Trump. He seemed enthusiastic about providing healthcare coverage during the election, even acknowledging that is wasn’t a traditional Republican sentiment. Is it possible that he intends to forge a Democratic alliance for a single-payer, public option? Well, the Democrats could at least suggest possible ACA fixes, if not “Medicare-for-all,” since the Republicans have failed.
Join The Wright Report tomorrow for part two of The ACA Fix (no one is talking about…) when we’ll suggest possible solutions for repairing “Obamacare.”