Today marks the 14th anniversary of the signing of the Affordable Care Act ("Obamacare"). From the Obama Foundation:
Once again, this landmark legislation is under threat by the Christofascist MAGAt Republican Party and its cult leader:
On Saturday, Biden and Obama plan to mark the anniversary with a virtual campaign event, as part of a broader effort to put the law at the center of Biden’s presidential reelection campaign. The idea is to remind voters about what the Affordable Care Act has accomplished ― and what could happen to it if Donald Trump retakes the White House.
There is a lot to say on both counts.
Tens of millions of Americans now get health insurance through the Affordable Care Act, either via expanded state Medicaid programs that the ACA funds or subsidized private coverage that the ACA makes available. Together, those features have brought the proportion of Americans without health insurance to historic lows.
The law also introduced legal guarantees of coverage for people with preexisting conditions. Those matter because, back in the day, insurance companies could charge higher premiums to people with diabetes or a history of cancer ― or deny them insurance altogether. They could also sell policies that left out whole swaths of coverage, like maternity care or treatment for mental illness.
Now with Trump on the ballot again, those changes could be in jeopardy ― for reasons that are right out in plain view, but aren’t getting the close look they deserve...
Christofascist MAGAt Republicans have never had a viable alternative that came close to what the Affordable Care Act does. As Cohn notes, there's a reason their "repeal and replace" plans are always vague:
Their basic goal on health care, as with the rest of their agenda, is to scale back government spending, taxes and regulations of private industry. That serves their interest in shrinking government — which, in their telling, leads to a more efficient, ultimately more humane health care system.
But there’s no escaping the basic math of health care, which is that lots of people can’t get insurance without public programs or financial assistance from government. That is why projections in 2017 consistently showed Republican repeal alternatives would cause the number of uninsured Americans to skyrocket — and why it’s safe to assume that repeal would have the same results now.
“Trade-offs are inevitable in health reform, like in any complex policy issues,” Larry Levitt, an executive vice president at the health care research organization KFF, told me Friday. “You can’t just magically produce better coverage at lower costs.”...
And as far as protecting Medicaid and people with preexisting conditions? Forget about it:
Trump’s fellow Republicans are proceeding the same way. A new budget proposal from the Republican Study Committee, which represents the majority of House Republicans, includes key elements of repeal like deep cuts to Medicaid and a rollback of regulations on preexisting conditions.
So let's celebrate what no President or party had ever accomplished in the history of the United States: access to good, affordable health insurance. It's more proof that Democratic governance can lead to a better quality of life for millions. Let's also resolve not to let the MAGAts get their hands on the levers of government lest they return us back to the dark days when financial ruin was just one diagnosis away.
