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Happy Universal Health Coverage Day!
No, it doesn’t slide off the tongue as effortlessly as happy holidays, and no, I didn’t know until recently that the United Nations officially designated Dec. 12 to advocate medical care for all. But whatever. Two weeks before Christmas, with its sentiment of good will toward all, is an apt time to deck the halls with better health protections for Americans.
Instead, the Trump Administration is trying to take universal health coverage off life support.
The administration two weeks ago announced that states could allow residents to use Obamacare subsidies to buy skimpy insurance: plans that don’t cover the law’s minimum benefits or that discriminate against people with pre-existing conditions.
Voters, who just elected a Democratic House largely to protect the Affordable Care Act (ACA), should tell their state leaders to keep hands off its protections.
In one of the few instances in his adult life where he didn’t lie, Donald Trump made clear from the get-go that he wanted to kill the ACA. The law was a giant leap towards universal coverage, driving down the number of uninsured Americans to a record low. That’s important because without insurance, some people choose to forego necessary care for fear of its cost — and being constrained by unaffordability is to lack true freedom of choice.
Today’s GOP doesn’t’ care about that. Having been thwarted in an outright repeal of Obamacare by John McCain, the White House and its congressional flunkies have taken the death-by-a-thousand-cuts approach.
The latest nick is the subsidies for non-ACA compliant plans, even though the voters were clear that they support the part of universal coverage that includes sick people with pre-existing conditions. Attacking that protection in the ACA is, politically, the Achilles heel of GOP leaders’ fanatical opposition to the law; covering the sick is supported by majorities of voters, Republicans included.
Voters, who just elected a Democratic House largely to protect the Affordable Care Act, should tell their state leaders to keep hands off its protections.
Smelling blood, Democratic congressional candidates lunged during the midterms campaign. They had ample fodder besides last year’s failed repeal attempt, including a current lawsuit filed by GOP attorneys general seeking to strike down the ACA. (By their suits ye shall know them.)
The White House did its party no favors in the run-up to last month’s voting. The Trump Justice Department asked the Texas court hearing the suit to gut Obamacare’s pre-existing conditions coverage. Vice President Mike Pence meanwhile promised another full-court press to repeal Obamacare if Republicans retained congressional control.
We know how that turned out. The party held the Senate but took a 40-seat thumping in the House, which flipped to the Democrats after 80 percent of the party’s candidates advertised their health care stance.
So now we face a two-front war: the lawsuit (which even an analyst with the conservative Hoover Institute, who directs Stanford Law’s Constitutional Law Center, calls preposterous), and the funneling of taxpayers’ money to plans with potentially inadequate benefits or protections for the sick to sign up.
I doubt Massachusetts, where I live, will do anything so heartlessly dumb. But states that have refused to expand Medicaid for their poor residents? I’m not so sure. If they take up Trump’s subsidy offer, some analysts predict a death spiral for Obamacare-compliant plans in those states. Healthy people will flee those plans for stripped-down, cheaper and now subsidized ones. With fewer and sicker customers, Obamacare-compliant plans will have to hike their premiums.
Hell of a health reform our president’s cooking, isn’t it? He obviously is ignorant of or indifferent to two salient realities. First, as the Nobel-winning Harvard economist Amartya Sen notes, poor nations have proven that affordable, universal coverage can be had “if the society, including the political and intellectual leadership, can get its act together.”
Intellectuals on the American right, Sen writes, are too often in the grip of the libertarian delusion equating universal coverage with socialism. That leads us to the second reality: Universal insurance hasn’t been achieved by any nation, even those with private insurance, without some government regulation and subsidy.
Recall that mandatory national health insurance was first enacted by the German anti-socialist strongman Otto von Bismarck in 1883 (real bleeding hearts, those dictators). More than a century later, a conservative hero of mine, William F. Buckley, said that Canada’s single-payer system was better than (pre-Obamacare) America’s, beset as we are with costly, unnecessary care. He quickly added that we ought to devise a third way superior to both.
Obamacare, invented by the right-wing Heritage Foundation and test-run by Mitt Romney in Massachusetts, was the beginning of that better, conservative alternative. And yet the conservative party on Universal Health Coverage Day is drunk on anti-Obamacare punch. The courts and voters should take away the punch bowl.
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