You know what boils my blood?
Hearing all of the GOP presidential candidate frontrunners vowing to repeal Obamacare once they are in office.
To me, this is purely an "us vs. them" move. Conservatives vs. Liberals. Is it just a matter of jealousy? Is the GOP jealous that a Democrat president beat them to the implementation of a wildly successful nationwide healthcare access program? Is this why Congressional Republicans have voted over SIXTY TIMES to repeal the Affordable Care Act? Quite honestly, the jealousy angle is the only thing that makes sense to me. However, I have yet to hear a candidate propose a replacement plan for Obamacare.
I would hate to think that the alternative is true: that GOP candidates want to take health insurance away from the people who most need it, people who HAVE it now under the Affordable Care Act. They claim that they want to repeal Obamacare as an act of "liberty," a return to American "freedom," a fight against government control in our lives. But here's the thing - most of the people complaining about the infringement on their rights DON'T EVEN HAVE TO RELY ON OBAMACARE. Sure, they can paint it as 'sticking up for the little guy,' but I'm pretty sure the 'little guys' here are enjoying their access to affordable healthcare.
Perhaps a look at some common GOP-propagated myths will help us understand this insanity.
Myth #1: Obamacare is socialized medicine.
Not quite - it is a product of socialism, in the sense that everyone has access to it, but it is not funded solely by the government, the way socialized medicine is. Families and individuals with incomes in a certain range may qualify for a yearly tax credit to offset the cost of the health insurance plans available in the Marketplace. The tax credit comes from government funds, but it's the same idea as income tax refunds - and last I heard, the GOP is not against tax refunds.
Myth #2: Obamacare is a significant violation of your rights.
The right to go uninsured and pay out of pocket for all health-related costs? Yes. The right to die from a treatable condition because you couldn't afford the treatment? Sure. Other than that, your rights are fine. You can even retain your right to not participate in universal healthcare for a small fee. But honestly, why would you want to NOT have health insurance? I don't understand how this argument is working for the GOP candidates.
Myth #3: Obamacare is Big Government's way of controlling your healthcare decisions.
Only insofar as the decision of whether to have health insurance. And again, you can pay the yearly fine to be uninsured. The pundits make it sound like Obamacare is a dictator's dream: control who can access what, control what healthcare everyone gets, control everything related to your health.
Here's how the Marketplace actually works: you create an account with basic information about yourself, your income, your pre-existing health conditions, and your household living situation. And if this sounds like Big Brother, just remember that the NSA can collect more information on you through your phone and internet usage in ten minutes than is contained in your Marketplace application. Plus, HIPAA protections are still a thing. Relax. Based on your answers, particularly the ones about your income and the number of people in your household, either your application will go to your State Department of Health to determine Medicaid/Medicare eligibility, or you will be sent on to the actual Marketplace, where you can peruse health plans available in your state. You can see who the providers are, what the plan's yearly deductible and monthly premiums cost, what the plan covers, what the plan doesn't cover, and links to more information from the provider's website. Let me say this clearly: YOU GET TO PICK THE PLAN YOU WANT HERE. You are not assigned to a plan; you get to see all the options, not just the ones the site thinks you can afford; and none of the plans is provided by the federal government. In fact, since the providers are private companies, the Marketplace is a great example of the free market at work - several companies competing to be your health insurance provider, meaning that they are each trying to offer their services at a price that is just a little bit lower than the other companies' prices! How does the GOP not want this shining beacon of capitalism preserved?
Now, if you're bounced to the Medicaid route, then yes - in a sense, your healthcare decision has been controlled by the government. But even within Medicaid, there is a choice of providers (in Michigan, at least, which is the state I live in). In fact, I think I had a choice of 5 different providers when it came to my application. If you don't choose a plan, the state will choose one for you, but that doesn't mean you have to use it. Plus, you can appeal the decision that bounced you to Medicaid, and then you pay that yearly fine to go without insurance.
For most people, their employer has more control over their health insurance than the government does. the Marketplace is designed for people who are unemployed, who don't get health benefits through their job, or who opt out of employee health benefits. It's likely that your employer offers fewer options than the Marketplace does.
Myth #4: Obamacare is destroying the economy.
The economy is a complicated monster, but here's a basic rebuttal to this "economy destruction" claim. If people have affordable healthcare, they don't have to spend as much of their income on doctor visits, prescriptions, treatments, counseling, etc. If they are saving money in this area, they can spend it in other areas, like food, housing, clothing, family life, transportation, or, best of all, entertainment and material possessions. This will cause an increase in demand, which will encourage an increase in supply, and through some voodoo magic, a revitalized economy.
Here's another approach: if people can afford to meet their healthcare needs, they will be more healthy (imagine that). If they are healthy, they can go to work regularly and enjoy a high rate of productivity. From what I've heard, a strong economy needs consistent productivity, not flash-in-the-pan ventures. If people can generally rely on a steady job, steady economy, and steady access to basic need fulfillment, their stress levels go down. When stress goes down, mental and physical health goes up. And healthy people go to work.
Myth #5: Obamacare is just another program that we don't need and can't afford.
And a corollary - Obamacare is going to cost way more than Obama says. Here's what's happened instead: almost 30 million people have obtained insurance since 2013 thanks to the Affordable Care Act. That's people who weren't insured before, not people who have switched to Obamacare offers. Put another way, 18% of adults in this country didn't have insurance in 2013. Now, that rate is down to 12.3%. Repealing the ACA will put 30 million people back where we started, possibly even more people than that, based on GOP promises to make drastic cuts. Can you honestly get behind a candidate that wants to ruin people's lives like that?
As for the overall cost of Obamacare, the Congressional Budget Office estimates that federal subsidies (those tax credits I talked about earlier) will cost $208 billion less than projected initially. That's billion with a B. That surplus will go to cover deficits in other areas of the national budget. But, then again, Republican presidents seem to be more comfortable with budget deficits.
Myth #6: "Illegal immigrants are going to pour into this country now that they can get free healthcare."
Where to begin on this one...first of all, UNDOCUMENTED IMMIGRANTS is the appropriate term. Second, undocumented persons cannot apply for Medicaid or Marketplace plans because a social security number is required. The ACA doesn't provide free healthCARE to anyone, only free health insurance coverage. And only in very specific circumstances. Most people still have some premium costs or pay-sharing programs to contribute to. Emergency rooms are still required to provide emergency care to everyone, including undocumented immigrants, but that law was in place way before the ACA was passed.
I'm now tired of debunking myths. Let's switch to some facts, peppered with personal anecdotes and impassioned pleas for sanity.
1. The ACA made it illegal for insurance companies to deny coverage to individuals with pre-existing conditions. This meant that if a company found out that you had, say, depression, they could deny your application because it would cost them more to insure you than it would cost to insure someone without depression. This sort of discrimination is what caused so many people to be uninsured. It could have caused me to be uninsured. Now, people don't have to worry about that when applying.
2. The ACA allows parents to keep their kids on their insurance plan until they turn 26. Personal anecdote time: I turned 26 last October and I was not looking forward to it because I knew it would mean that I'd lose my dad's primo health insurance. That policy covered almost everything; most notably, unlimited counseling, physical therapy for vertigo, and incredibly dental services. The previous age was 22, I think, and I am so thankful that the age was raised to 26. I used more health services between ages 22 and 26 than I used in the previous twenty-two years combined. I wear glasses ($250 per pair), I take two prescriptions every day (almost $100/month for both in addition to the 15-minute psychiatrist visits 4 times per year to get the prescription) plus a number of over-the-counter supplements, I see my therapist once a week ($140/session), and I've had two episodes of disabling vertigo in the last year (I don't know what the physical therapy treatments cost). With five of us contributing to the yearly deductible, I didn't even have to make co-payments after, like, February every year. I miss that insurance so much.
3. The ACA is improving people's lives, if not completely saving them. One example - my mom is a physical therapist's assistant and her company has seen its number of clients soar because of the Medicaid expansion. And this is not just clients who want a massage, or are rehabbing a sports injury. These are people who are chronically unemployed because of chronic pain from a decades-old injury. These are people who have been injured on the job and worker's comp didn't cover their needs. These are people whose every last dime goes toward food, clothing, housing, and childcare, and who never dared dream that PT was within their reach. Can you really tell me that it is in our nation's best interest to keep "the least of these" trampled under our feet? Where is the Christian family value in that?
4. The ACA indirectly lightens the burden on community agencies that provide healthcare. This year, I'm working at a school that serves a high percentage of low-income families. We're talking Free and Reduced Lunch Program participation at 85% of students. Cherry Street Health Services provides free vision and dental check-ups every year to students who qualify for them. The dentists were at our school right before Christmas break and I made small talk with one of the dentists while I waited for a student I was working with. She told me that the number of students they've seen in schools has been declining in the last few years. I asked if this was a good thing or a bad thing, and she said that the decline was the result of increased access to Medicaid and Obamacare. This meant fewer free check-ups to provide, lowered stress levels for clinicians who were serving a population that just kept growing, and less strain on the budget for providing services to uninsured clients. So yeah...fewer student participants was a great thing.
5. The ACA represents a move forward for the United States. All this GOP talk about "restoring America's glory" and "making America great again" generally makes me roll my eyes because the ACA is a piece of legislation that caught the US up to other developed nations. Access to universal healthcare overwhelmingly raises the standard of living, longevity, emotional health, and prosperity of a nation's people. Why would the GOP not want this?! How does the GOP propose to "make America great again" if they're champing at the bit to cut off access to health insurance for 30 million of their own citizens? Does this party really represent the interests of our people?
By way of conclusion, a personal plea - please don't vote for any GOP candidate who promises to repeal the Affordable Care Act. The ACA has saved my life - from the extra four years on my dad's insurance to the expanded Medicaid access that I use now until I land a career job. The ACA has allowed me to attend over 150 therapy sessions for free in the last 3 years. The ACA provided me with physical therapy for vertigo, enabling me to return quickly to work and school. The ACA allowed me to put my money toward graduate school and training for a career that I absolutely love, instead of having to spend it on healthcare. Most of all, the care I've received under the ACA has kept me from giving in to depression, a condition which has tried to knock me out every day.
Please don't put anyone in office whose platform is to ruin my life and the lives of 29,999,999 other Americans.
