While pundits and politicians watched last week’s congressional health care debate and discussed vote counts and trade-offs, thousands of Kansans and Missourians and millions of other Americans anxiously awaited the outcome of the debate over the GOP health bill that ultimately was pulled. They were not focused on Congressional Budget Office scores or risk pools, but were desperately trying to figure out whether they were in danger of losing health care coverage that has provided access to doctors and medicines — and peace of mind.
Twenty million people, young and old, healthy and sick, have affordable health coverage that wasn’t available to most of them until 2014. And in spite of the frequently-repeated Republican claim that Obamacare is a failed program, the 12.2 million people who enrolled in health plans for 2017, and those folks who are now eligible for Medicaid benefits, are very pleased with their coverage and financial security. The claims of a market collapse are not evident in markets across America where over 80 percent of consumers paid no rate increases because their tax subsidies increased with the rate increases.
So after seven years of partisan battles and votes to repeal the health care law, what did the Republicans propose? The American Health Care Act would have reduced income-based financing from the government to assist people who don’t have an employer paying a share of their health care to buy their own health insurance. The cost-sharing now available to the lowest income workers to help pay deductibles and co-pays would have been eliminated. And older Americans could have been charged five times what younger folks will pay for the insurance. That would have dramatically increased the costs for older — and often sicker — Americans.
The Republican proposal would have stopped the Medicaid expansion and gradually eliminated coverage for most of the newly insured low-income workers by changing eligibility rules and eliminating additional federal resources. The GOP proposal would have de-funded Planned Parenthood for a year, disrupting millions of women’s choice of their own health providers for reproductive care and cancer screenings. And buried in all the other bad news was a fundamental shift in the 50-year partnership between the states and federal government for Medicaid, so that services to the disabled, poor seniors in nursing homes, and pregnant low-income mothers and their children were threatened by a cap on federal funds, and a cut over 10 years of almost $900 billion dollars. Most of those so-called savings from the most vulnerable in our communities would then have been given in tax breaks to insurance and drug companies, and to the wealthiest Americans.
According to the non-partisan Congressional Budget Office, the Republican health law would have taken away health coverage from up to 24 million people in the next 10 years — 14 million as soon as next year — and insurance premiums and out-of pocket costs would have increased. Moody’s predicted that many states would face a financial downgrade if the Medicaid funds were reduced so drastically, and the bill was opposed by every group of health providers including doctors, nurses and hospital leaders.
After seven years, the Affordable Care Act has produced the lowest number of uninsured individuals in history. Over 90 percent of Americans now have health insurance. Overall medical inflationhas increased at the slowest rate in 50 years, and we now have fewer medical bankruptcies. As President Barack Obama said, “This debate is about more than health care; it’s about the character of our country.”
I continue to believe that most Americans think everyone should have health care. And while the current law is far from perfect and would benefit from some bipartisan improvements, it is by any measure — coverage, cost, continuity of care — vastly superior to the law Republicans proposed and then couldn’t pass last week.
Kathleen Sebelius is a former governor of Kansas and was secretary of health and human services under President Barack Obama.