Six months into President Trump's term, the Republican majority in Congress has largely been consumed by its effort to repeal the Affordable Care Act. This is unsurprising, given the GOP has been fixated on repealing "Obamacare" for the past seven years.
At the time of passage, we all recognized that the ACA was far from perfect, but its benefits for many Americans were undeniable. America's uninsured rate has dropped to its lowest point in 50 years, millions more Americans have access to a doctor and do not risk financial ruin when they get sick or injured.
Unlike most legislative battles, the partisanship surrounding the ACA's passage has continued through its implementation. Congressional Republicans have fought to weaken the law rather than address changing conditions in the healthcare market or any deficiencies. Now in control of the White House, President Trump has taken steps to undermine the Affordable Care Act and cause its collapse, by withholding payments to insurers and creating destructive uncertainty in the market. If insurers cannot count on the Trump Administration to make required payments, they must raise premiums dramatically or leave the market — just the kind of death spiral the president hopes to create.
I supported the ACA in 2010 because I believed then, as I do now, that healthcare is a human right and it ought to be universal. I supported including a public option in the ACA that didn't make it into the final bill, because it would have further constrained costs and created additional competition.
That is a concept I still support, because in the wealthiest nation in the world, it is unconscionable that millions of Americans, including children, go without access to care. For millions of families, a bad diagnosis can mean bankruptcy. For the parents of children with a congenital heart condition or other birth defect, it means a lifetime of worry not only about their child, but what will happen when they hit their lifetime limit and potentially owe millions.
The ACA did not fix every issue in our healthcare system, but it created a framework to get us the rest of the way. Through Medicaid expansion, millions more low-income Americans became eligible for coverage. Moreover, by creating a system of insurance exchanges and subsidies to help those who did not get coverage through their employer, the ACA created a market-based solution to expand access and affordability. And it worked.
Now, seven years later, Congressional Republicans are forging ahead with a bill that President Trump called "mean." It would force more than 20 million people off their coverage, allow states to opt out of protections for preexisting conditions and lifetime limits, and most importantly, gut coverage for millions of children, disabled and elderly Americans. This bill would cut $800 billion from Medicaid in the first 10 years — and hundreds of billions more later — to give a major tax cut to the wealthy.
The Senate bill is no better and may become worse still. The Republicans who tout it do so because of the tax cut it creates, not its purported health-policy solutions. Yet Republicans push forward because they feel compelled to repeal the ACA, no matter how many Americans suffer as a result. That either chamber would tout a bill that cuts off tens of millions of Americans and is supported by only 16% of the public is as perplexing as it is wrongheaded.
The battle we fight today should be about expanding coverage to millions more, not deciding how much coverage we should take away from people who already have it. Whether Congressional Republicans are successful in their repeal efforts or not, universal healthcare must be our goal.
As President Trump realized all too late, healthcare is really complicated. But our priorities should not be: We must endeavor to provide quality, accessible care to every American.