US health care update

While I write about US political issues sometimes, I haven’t been recently, not because there hasn’t been a lot to write about, but because there has been too much – and not enough time, as I have been dealing with multiple family health issues.

I can’t bring myself to try to elucidate the increasingly alarming tangle of DT’s campaign, transition, and administration with Russian government and oligarchs, Cypriot banks, Turkey, surveillance, investigations, and the firing of justice officials, but I do want to comment on the failure of the Affordable Care Act (ACA) repeal.

The ACA has been an important law that has had a positive effect on my family and on many millions of Americans. We have all benefited from provisions that all insurance cover a suite of important health care provisions without deductible and copayments, that there be no annual or lifetime caps on coverage, and that pre-existing conditions must be covered. While premiums have increased as projected, the rate of increase has been lower than in the years before the ACA and the subsidies based on income have kept pace with the premium increases to keep insurance affordable for most people.

There have been some problems, the biggest being the gap caused when some states chose not to expand Medicaid eligibility as designed in the original legislation, a provision that was overturned by the Supreme Court. This left low-income folks in those states without a path to get subsidies for their insurance.

If Congress had been functional, the ACA would have been amended to deal with the various problems and to enhance the programs for the benefit of the public, as happened with other large programs, such as Social Security.

However, Congress has not been functional for years. The Republican leadership has refused to bring bipartisan legislation up for a vote, deciding that the ACA should be repealed in its entirety. Instead of enacting fixes and enhancements, the House voted dozens of times to repeal the ACA, a meaningless gesture as it would not pass the Senate and be signed by the President.

With DT’s inauguration and the Republicans in the majority in both houses of Congress, many of us feared that the ACA would be repealed and a more expensive and less extensive health care insurance program be put in its place.

The bill that was proposed was even worse than we had feared, with projections that 24 million people would lose insurance coverage, even more than were without coverage before the ACA.

And then it got worse, due to wrangling among the Republicans. Even the essential benefits were put on the chopping block.

The people had not been silent during this whole debate. Congressional offices, which had already been flooded with calls, visits, town hall attendance, emails, letters, faxes, postcards, and the occasional delivery of pizza or baked goods with a message attached, experienced even higher volumes of contact, with pro-ACA messages outnumbering repeal/replace messages by margins of hundreds or thousands to one.

DT got involved, pressuring House members to vote yes. The vote, scheduled for Thursday, which was the seventh anniversary of the signing of the ACA by President Obama, was postponed until Friday morning, then Friday afternoon.

Then, at the time it was supposed to begin the voting process, the announcement came that the bill had been pulled.

There was a huge sigh of relief.

And a cloud of uncertainty.

The best outcome at this point would be for Congressional committees to consult with health care providers and policy experts to craft repairs and enhancements for the ACA to benefit public health and well-being and to pass those amendments into law.

Which many of us have been advocating for years.

Maybe the Republicans will finally cooperate in this process.

We, the people, will continue to demand that they do.