“I’m covered?” He slapped the table. He clapped twice. “Woo-hoo! I can go to the doctor now?”
That was the shocked response of Jeff Fletcher, a disabled 52-year-old electrician in rural Kentucky, after being told he qualified for health insurance despite several preexisting conditions, thanks to the Affordable Care Act (ACA), aka “Obamacare.”
Documented in a Washington Post article, scenes like this are the reason City on a Hill Press firmly support ACA’s expansion of coverage, despite widespread opposition to the law and Healthcare.gov’s disastrous rollout. This year represents a turning point in ACA’s troubled saga. Though it still falls short of a different system we’d prefer, by the end of the year we think most Americans will agree with us that the law is a definite step in the right direction.
That’s because on Jan. 1, after four years of bitter political struggle, the coverage extended by ACA to millions of previously uninsured Americans finally went into effect.
Now that Americans are actually receiving healthcare services through the law’s exchanges and its expansion of Medicaid, a highly contentious debate that was once abstract will soon become increasingly concrete.
Republicans had a field day in recent months with the delays and technical glitches that characterised the botched Healthcare.gov rollout. And the GOP’s other favorite talking points will still raise a furor at town hall meetings. Yes, the law will require younger, healthier Americans to lose their current bare-bones coverage. Yes, they’ll have to buy more expensive and comprehensive plans, in effect subsidizing their older, sicker counterparts. Yes, the law creates a lot of red tape for businesses, especially small ones.
ACA is admittedly far from perfect, and liberals too have qualms with the law. Many, most recently Michael Moore in the opinion pages of the New York Times, blasted it for selling out to insurance companies by stopping short of establishing a “public option” or single-payer system, where the government would set up its own, not-for-profit insurance outfit as it does with Medicare and Medicaid.
These types of government-run insurance plans provide excellent and cost-efficient care in countries like France and the U.K., and ACA’s failure to establish one is perhaps the law’s greatest shortcoming.
But as the Healthcare.gov episode subsides and millions of Americans start to experience the benefits of continuous, affordable health insurance, its undeniable positives will begin to shine through. The aspects that have drawn the GOP’s ire are a small price to pay for a law already expanding coverage to roughly 9 million Americans. As more and more Americans are able to see a doctor regularly — nipping illnesses in the bud before they get out of hand — overall healthcare costs will decrease, just as the Congressional Budget Office predicted. The law also puts a stop to the awful situation many Americans previously found themselves in — suffering from long term illnesses and unable to get insurance because of it.
The fact that the system set up by the law still depends mainly on private, for-profit insurance companies is nevertheless a disappointment to many on the Left.
The U.S. healthcare system produces the worst outcomes and incurs the highest overall costs of any developed country. Case in point: medical bills are the number one cause of personal bankruptcy in the U.S. A major difference between the U.S. system and that of other developed countries is our reliance on private, for-profit insurance companies. Still, even on this front there are reasons to be optimistic as ACA coverage becomes a reality in 2014.
By far the largest portion of previously uninsured Americans, roughly 4 million, who received coverage under the law are those benefiting from its expansion of Medicaid, the government run insurance system for low-income Americans. As millions of low-income Americans, including working-class GOP supporters, begin to experience affordable healthcare for the first time, they’ll want to keep their coverage, not dismantle it. Add to that the millions more Americans buying insurance on the exchanges for the first time, and you’ve got a constituency that will want more coverage cheaper — not less.
As Noam Scheiber writes in a recent New Republic article about this phenomenon, “The basic point is that, by pooling millions of people together in one institutional home — the exchanges where customers buy insurance under ACA — the Affordable Care Act is creating an organized constituency for additional reform.” He goes on to assert that “flawed as ACA is, it has at least one great virtue: laying the groundwork for its own fixing.”
If that turns out to be true, then 2014 might just be the beginning. And if that means more people so overjoyed to finally see a doctor that they’re slapping tables and clapping their hands, then that’s definitely a step in the right direction for the American people.
