Truth be told, health care reform (known as the Patient Protection and Affordable Care Act — henceforth, I will refer to it as ACA) is far from perfect. It’s as far from perfect as I could ever craft a piece of legislation designed to expand access to health care.
If I’d had my way, the private, for-profit health insurance industry would no longer exist, and Medicare would cover everyone in this country. We’d have a national, universal plan — like just about every other industrialized nation in this world — and no one would have to worry about going broke because of medical bills ever again.
However, such a plan (known as single-payer) was never politically possible; in fact, it was taken off the proverbial table before the debate even begun. To find out why, Google political donations from health insurance companies and you’ll have your answer.
When this bill was being debated, a compromise to single-payer was discussed called the public option. Essentially, this bill creates insurance exchanges, available starting in 2014, designed to increase competition in the market and drive down prices. One of the plans that would’ve been available in the exchanges — the public option — was a government-run alternative available to those who were not already covered.
Because of political malfeasance (from Republicans and a couple Democrats in the Senate), the public option never passed, either. This left us with a long, complicated piece of legislation that prompted people to buy insurance (the individual mandate), without offering a profit-free alternative.
On the surface, the ACA appeared to be a bailout of the insurance industry.
But there’s a say in politics: “Never let the perfect be the enemy of the good.” A lot of liberal voices were apoplectic when the public option died, saying health care reform was no longer worth the effort. Without the public option, they argued, there was no point.
Never mind what the ACA, which survived today when the Supreme Court decided 5-4 the law — and its individual mandate — was constitutional, actually does.
There is no single payer, there is no public option. But the reforms housed within the ACA are worthwhile, and they serve as a check against the private insurance companies. If some liberals had their way, and the ACA died when the public option fell through, we’d be in the same state we were before the ACA passed.
Pre-existing conditions would still be a problem, both for children (who are now protected) and adults (who will be protected once the exchanges are formed in 2014). People could still lose their policies simply because of getting sick (called rescission — no longer legal thanks to the ACA).
Because of the ACA, young people can remain on their parents’ insurance plans until they turn 26 — a godsend for recent college graduates struggling in a difficult job market. Because of the ACA, senior citizens are receiving rebates as the law slowly closes Medicare’s doughnut hole.
Because of the ACA, insurance companies how have to spend 80-85 percent of premiums on actual health care — and refund you the difference if they don’t. Because of the ACA, insurance companies have to inform you (and regulators) if they plan on raising premiums.
If President Obama and the Democrats packed up and went home once the public option bit the dust — as many suggested — none of those advances would be possible. There is plenty of work to be done — the ACA does not offer universal coverage — but this law does good things.
More importantly, assuming we re-elect President Obama and the Democrats can regain control of both houses of Congress (which means we have to vote), we can build on this law down the road. No one ever said the ACA was the end-all, be-all of health care law in this country.
The reason we haven’t seen additions to the ACA is that we’ve spent so much time defending it the last two years — both in court and against repeal attempts in the GOP-controlled House.
The ACA is helping people, and it will continue to do so over the next few years while more and more of its provisions take effect. There is further work to be done, both in terms of expanding access and reducing costs, but the ACA is a solid start. I’m glad the Democrats didn’t abandon the bill, and I’m glad conservative attempts to undo it have, to this point, failed.
You want to scream about all the things wrong with the ACA? Fine, go right ahead. There are flaws with this law — no piece of legislation is ever perfect — but it is doing good things, and there is opportunity to do more in the future.
Keep fighting for single payer; just don’t disregard this law along the way.