For those who have come to appreciate the value of more accessible individual health care over the past seven years, survival of Obamacare takes on a personal dimension.
When the Republicans in Congress and President Donald Trump were unable to agree on how to “repeal and replace” the Affordable Care Act last week, many people celebrated, and some may have gloated. It turns out that health care is complicated, and it is difficult to take away something that people actually like and use and have come to count on.
But improving Obamacare was not what House Speaker Paul Ryan’s proposal, which the president supported, would have done. It would have made health care less accessible for 24 million people, according to the Congressional Budget Office.
The Freedom Caucus hard-right conservatives in the House of Representatives were demanding total repeal. Philosophically, they don’t believe government should have any role in providing health care for people of little or modest means. Apparently, members of the Freedom Caucus feel requiring people to support a national health plan is more unAmerican than letting fellow citizens suffer for lack of health care. Happily, they are in the distinct minority.
In any event, those who feared the loss of near-universal health care took heart at week’s end as middle Americans apparently pushed back enough to be felt by moderates in Congress, and Ryancare slid off the table.
So, if you think everyone should have access to health care or health insurance, you had the weekend to rest at the oars. But now it’s time to resume your vigilance and civic engagement, because even if the right-wing billionaire Koch brothers and their Freedom Caucus failed to repeal Obamacare, and Paul Ryan won’t want to touch that electrified rail any time soon, there’s reason to worry the Trump administration will do little to stabilize the current system.
Trump’s assertion that Democrats will be sorry when the current health care system “explodes” and will come begging to “deal” sounds more like a threat than a prediction. He has the tools at his disposal to wound or help fix Obamacare. Human nature being what it is, we worry he may be more inclined to choose the former to prove himself right.
There are many ways the Trump administration can undermine the current law — or try to stabilize it. Trying to make Obamacare work by trying to make health care insurance better and cheaper would be the right thing to do. It’s what he campaigned on, and, we hope, what he actually believes.
He already issued an executive order telling the IRS not to penalize those who don’t buy into the ACA, wounding it financially. Reversing that would be a good start and would signal to his constituents that he does care.
Another question is how the administration will handle the next enrollment season. When he first took office, Trump pulled the plug on spending to encourage enrollment. Instead, in the coming year he could let people know about their options under the current law and help them sign up.
The White House can administratively hold back on ACA subsidies to insurance companies, which enable them to reduce out-of-pocket costs for lower-income enrollees. That might drive some carriers from the market. We hope that White House doesn’t go there, either.
We’re hoping a clear take-away from last week is that many Americans support some form of Obamacare and that only 17 percent supported what Trump and Ryan were peddling. Most Americans do see a role for government in providing health care and do want what they have now fixed, not spiked.
The ACA isn’t perfect, even Democratic progressives admit this. And if we can’t count on the White House to help improve the ACA, then we, the public, need to encourage moderates on both sides of the aisle in Congress to recognize that providing adequate health care for all is important enough to work together to figure this out, rather than to play some strange game of chicken with people’s well-being at stake.
This is what moderates in Congress, our admittedly more liberal delegation from Massachusetts, lobby groups and anyone who supports government-assisted health care for the needy, the poor and the elderly, should support.