J. David Ake, Associated Press
WASHINGTON — There’s a big difference between principle and pigheadedness.
While claiming to uphold the first, congressional Republican opponents of the Affordable Care Act (Obamacare) are really engaging in the second. It’s time for the GOP to accept that the ACA is the law of the land, recognize the good it has done and will do, and work with Democrats to fix the defects that are inevitable in such a large and complex program.
Diehard denouncers of the ACA seem to have forgotten the past, are ignoring the present and are heedless of the future.
Before health care reform, insurance companies denied coverage because of pre-existing conditions; limited their insured’s yearly and lifetime benefits; and often dropped policies altogether when medical bills got too high, just when families needed coverage most.
The individual insurance market was an uncharted jungle, with no easy way of comparing costs and benefits; young adults just starting out in life couldn’t afford coverage; and seniors were paying too much for prescription drugs.
Most significantly, before health reform, almost 46 million Americans lacked health insurance.
Since reform, no one can be denied coverage because of their health history; there are no caps on benefits, so families aren’t plunged into bankruptcy by big medical bills; and coverage can’t be dropped just because someone gets very sick.
Insurance policies can be shopped for online like plane tickets and hotel rooms, with a website exchange — now working well — providing side-by-side comparisons of rates and benefits; adult children can stay on their parents’ policies until age 26; and the “donut hole” in the Medicare prescription drug benefit is being closed.
Most significantly, when the first open enrollment season under the new health care law closed on March 31, 7.5 million people had signed up for private insurance, while an additional 3 million had been enrolled in Medicaid.
The Medicaid number would be much larger if certain Republican governors had not for political reasons rejected federal aid to expand their state health programs.
Looking to the future, health care costs can either return to the unsustainable trajectory they were on before the ACA, or continue on the more restrained path they’ve been on since reform.
Workers can go back to losing their health insurance when they lose their jobs, or can have an independent source of quality, affordable coverage. The Medicare prescription funding gap can continue to shrink away, or remain a financial hole for seniors.
And congressional Republicans can either continue their pattern of destructive obstruction or decide to act collaboratively to make the law better.
Certainly, there’s work to do. Republicans have, hypocritically, criticized the Obama administration for delaying and amending certain elements of the law in response to real-life experience. But those are precisely the kind of on-site adjustments the GOP should be supporting and helping to formulate.
There’s a model for such Republican cooperation. While some GOP governors, as noted above, are callously denying their lowest-income citizens a chance for Medicaid coverage, others are taking a more humane and rational approach.
Ten Republican chief executives — including several staunch conservatives, like Jan Brewer of Arizona and John Kasich of Ohio — have expanded Medicaid or are considering doing so.
Meanwhile, five Republican-led states established health care exchanges, either on their own or in partnership with the federal government.
Change is hard, big change is harder still. We can’t effectively reform our health care system — which represents one-seventh of our economy and affects every American — with half of our nation’s political leaders either sitting on their hands or rooting for failure.
Now is the time for the congressional GOP to put aside ideological and political arguments and get to the business of making sure the Affordable Care Act works for everyone.
William Rice is a policy consultant with Americans for Democratic Action. Readers may write to him at ADA, 1629 K Street NW, Suite 300, Washington, D.C. 20006; website: www.adaaction.org.
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