Affordable Care Act Update

 This post is quoted directly from Boston College historian Heather Cox Richardson from Letters from an American <heathercoxrichardson@substack.com>
Date: April 5, 2022 

Obama signed the ACA into law in 2010. Today, 31 million Americans have healthcare coverage thanks to it. They can’t be denied coverage because of preexisting conditions. The ACA has lowered prescription drug costs for 12 million seniors, and it has enabled young people to stay on their parents’ insurance until they’re 26. It’s eliminated lifetime limits on benefits.

Republicans have loathed the ACA since Obama signed it into law in 2010. This is a modern-day stance, by the way: it was actually Republican president Theodore Roosevelt who first proposed universal healthcare at the beginning of the twentieth century, and Republican president Dwight Eisenhower who first tried to muscle such a program into being with the help of the new department created under him: the Department of Health, Education, and Welfare, which in 1979 became the Department of Health and Human Services. Its declared mission was “improving the health, safety, and well-being of America.” In contrast to their forebears, today’s Republicans do not believe the government has such a role to play.

Last month, Senator Ron Johnson (R-WI) said the Republicans’ goal is to obstruct Biden and the Democrats until they retake power, and then immediately make good on old promises like repealing the ACA. Senator Rick Scott (R-FL), chair of the National Republican Senatorial Committee, has proposed sunsetting all laws after five years and then passing the popular ones again. Since Republicans kill all social welfare bills with the filibuster, it’s not hard to imagine that Scott has the Affordable Care Act in his sights.

Enrollment in healthcare coverage under the ACA is at a record high since Biden took office, since he helped to push enrollment by opening special enrollment periods and dramatically increasing outreach. The law is popular: a poll last month by healthcare analysts Kaiser showed that 55% of Americans like it while 42% do not.

Today, Biden signed an executive order to increase outreach and coverage still further, and to urge Congress to deal with the “family glitch” in the law that determines eligibility for subsidies based on whether the primary enrollee can afford coverage for herself, rather than for her family. Fixing this glitch would lower costs for about 1 million Americans and open up coverage for another 200,000.

Before the signing, Obama, Biden, and Vice President Kamala Harris used the ACA to talk about the difference between the two parties.

Harris noted that “the ACA is the most consequential healthcare legislation passed in generations in our country” and that it was more than just a law, it was “a statement of purpose; a statement about the nation we must be, where all people—no matter who they are, where they live, or how much they earn—can access the healthcare they need, no matter the cost.”

She called on Congress to pass legislation that would let Medicare directly negotiate prescription drug prices with pharmaceutical companies (as every other developed country does). With 60 million people enrolled in Medicare, the program would have significant bargaining power to negotiate prices.

The vice president also called on the 12 states refusing to expand Medicaid to do so, enrolling the 4 million people who are now excluded. Acknowledging those people determined to take away abortion rights, she noted that women without medical care during pregnancy are significantly more likely to die than those who do have it.

Obama then explained why the Democrats worked so hard to begin the process of getting healthcare coverage for Americans. “[W]e’re not supposed to do this just to occupy a seat or to hang on to power,” he said. “We’re supposed to do this because it’s making a difference in the lives of the people who sent us here.”

The ACA shows, he said, that “if you are driven by the core idea that, together, we can improve the lives of this generation and the next, and if you’re persistent—if you stay with it and are willing to work through the obstacles and the criticism and continually improve where you fall short, you can make America better—you can have an impact on millions of lives.”

Then Biden took the podium before signing the executive order, adding that passing the ACA was about dignity. It was about the “countless Americans lying in bed at night, staring at the ceiling, wondering, ‘My God—my God, what if I get really sick? What am I going to do? What is my family going to do? Will I lose the house?’ Discussions we had in my house with my dad when he lost his health insurance—’Who’s going to pay for it? Who’s going to take care of my family?’”

He warned that the Republicans want to get rid of the law. “[P]ay very close attention, folks,” he said. “If Republicans have their way, it means 100 million Americans with pre-existing conditions can once again be denied healthcare coverage by their insurance companies. That’s what the law was before Obamacare. In addition, tens of millions of Americans could lose their coverage, including young people who will no longer be able to stay on their parents’ insurance policy to age 26. Premiums are going to go through the roof.”

“Instead of destroying the Affordable Care Act,” he said, “let’s keep building on it.”