For many, many reasons Americans in October 2020 are focused on the pandemic and health care issues. The election is upon us. So let’s look at the record.
For the last ten years the Republican Party has promised to repeal and replace the Affordable Care Act (aka, ACA or Obamacare). For the past four years Trump has promised the same. The Republican Party has failed.
This is how William Shakespeare might have described Republican plans if he was a 2020 network commentator rather than the 16th century author of Macbeth:
“Tomorrow, and tomorrow, and tomorrow … It is a tale told by an idiot, full of sound and fury, signifying nothing.”
Trump has many times said something about a great health care plan he will soon announce along with all the amazing improvements in drug coverage that he has in the works. Watch what he does, not what he says.
Here are the facts concerning health care legislation and litigation:
• Over the past four years the Trump administration has chipped away at the ACA protections through changes in federal regulations.
• There is a case before the United States Supreme Court that originated in Texas which would declare the ACA unconstitutional. The Court hearing is on November 10.
• The Trump administration supports that action, as do, it appears, all Republican elected officials and candidates.
• Trump has indicated that one of his motives in appointing Amy Coney Barrett to the Supreme Court is to make it easier for the Court to declare the law unconstitutional. Barrett has criticized previous Court decisions that upheld the law.
This is important stuff. Here is a summary of what the end of Obamacare would mean to tens of millions of Americans if the Republicans are successful:
• There are approximately 11 million people who have their medical coverage via purchase on the health care marketplaces established by the ACA. The law provides subsidies to the great majority of these individuals, and it is likely that millions of them, in the face of the pandemic’s economic recession, will not be able to afford continuing coverage if the law is struck down.
• There are an additional 12 million adults who receive health insurance through the expansion of Medicaid under the ACA in states that agreed to participate in the program; about three million children also received coverage when their parents enrolled in Medicaid. The numbers have grown as people have lost their jobs. The federal government covers 90 percent of the costs. Absent support of the law, many, perhaps most of the states will not be able to pay the full costs of the extended coverage, leaving most of these Medicaid beneficiaries without health insurance.
• Protections for the 100 million plus people who have pre-existing conditions would be eliminated if the ACA is declared unconstitutional. Trump’s “executive order” about the subject has all the force of a tweet. Republican members of Congress and this year’s new candidates are running for cover on this critical issue. Insurance companies, removed from ACA responsibilities, will either decline to offer such protections, or will only offer the coverage at a substantially higher cost.
• There are now more than 7.4 million Americans who have been infected with COVID-19. There is much evidence to suggest that even for those who have recovered from the virus there are lingering negative health issues – the type of thing that defines pre-existing conditions.
• The ACA prohibits dollar caps on coverage protection. Prior to the law going into effect many private insurance plans had hard dollar limits on the amount they would pay for medical needs, exposing people with major medical challenges such as heart disease, cancer and transplants to huge medical bills that can lead to bankruptcy and the loss of homes.
• The approximately 60 million seniors and the permanently disabled who have their coverage through Medicare will be negatively impacted by the end of the ACA. Preventive care including wellness visits is currently free. Seniors who buy their drug coverage through Medicare will see the emergence of the infamous “doughnut hole” which required many people to pay for a significant portion of their prescription medications even if they have Medicare coverage. Obamacare has been narrowing the doughnut hole.
• If the law is declared unconstitutional then the 0.9 percent increase in payroll tax for high income individuals would be eliminated, which will reduce money coming into the Medicare trust fund, an account that is already running low.
• Adults under the age of 26 who have had medical insurance under their parents’ policies will lose that benefit, which will leave many without medical insurance.
• Medicaid assistance for those dealing with opioid addiction will be negatively affected as people lose their coverage provided through the expansion of Medicaid. The law requires insurance carriers to cover substance abuse treatment and that protection would be lost too.
• Hospitals that are currently dealing with pandemic-related lost revenues and added operating costs have had some relief for the costs of providing medical care for uninsured patients under the ACA. The end of the law would see spikes in hospital costs as people once again rely in greater numbers on emergency rooms that are legally required to provide services to people who cannot pay.
All of the above benefits of the Affordable Care Act will go away if Republicans are successful in totally eliminating the law. The attack on health care for tens of millions of Americans goes further than Trump. Republicans who hold public office or are running for office have remained mute as Trump, Republicans in Congress and some judges have worked to destroy health care coverage. They have offered no alternatives, even after ten years.
Voters have a whole lot of things to consider as they vote this year. The threat to health care is right at the top of the list. Another reason why your vote is so critical.
Register to vote
If you, your friends or relatives are not registered to vote, in New York State you still have until October 9 to do so. If you mail the registration form to the Board of Elections it must be postmarked by that date and received by October 14. Here is a link to registering.