Not satisfied with taking away health insurance coverage for over 3 million Americans, last week the Trump Administration said it wanted to take away coverage from more. While Americans have been distracted by the scandals, investigations, and policy flip flops, the Administration and its allies in the Congress have never been deterred from one deadly mission – to strip away health insurance coverage from millions of Americans.
Most recently, the Administration announced that it will not defend the Affordable Care Act against the latest legal challenge to its constitutionality. As a result, new challenges to the law may succeed before the courts in a way they had not in past.
It’s clear that the Administration will do all it can to further strip away health insurance coverage from more millions of Americans.
Health insurance is the protection that most of us have from debilitating disease and financial ruin. For example, cancer. For cancer patients and their families, the cost of fighting cancer may mean choices that could lead to huge debts under the best of circumstances. While some individuals diagnosed with cancer have meaningful and adequate health insurance to cover most of the cost of treatment, the uninsured and an increasing number of privately insured individuals face the prospect of crippling out-of-pocket costs. Financial barriers that delay treatment for cancer can mean the difference between life and death.
More generally, even those with coverage face uncertainties; roughly 20 percent of people under age 65 with health insurance nonetheless reported having problems paying their medical bills over the last year. By comparison, more than half of people without insurance said the same.
For years, a huge problem in America was the rapid increase in the numbers of people without health care coverage. In the 1960s, the nation developed Medicare, health insurance for those over the age of 65 and Medicaid, health insurance for the poor.
In the 1990s, the President and the Congress expanded coverage to help cover all those under the age of 18. Yet, despite the fact that near-universal coverage existed for those under the age of 18, those over the age of 65, and the poor, the number of Americans without coverage continued to swell, peaking at about 50 million ten years ago.
For the rest of the advanced nations of the world, it was inconceivable that such a situation existed. Western Europe, Canada, Japan and others have health care coverage for all of their citizens. As a result, despite spending far more on health care than any other nation on Earth, the United States had more uninsured, incredibly uneven health care quality, and a mediocre life expectancy compared with other developed, wealthy nations.
Former President Obama and the Congress agreed to legislation than attempted to address that problem. The solution that they came up with had a modest impact on the spiraling cost of health care, but did cut in half the number of Americans that lacked health insurance.
You could argue their solution – one which essentially expanded the number of Medicaid-eligible Americans and offered subsidies to help others who were required purchase health insurance – was inadequate to the task, but no one could argue that they did not try.
For years, Republicans argued that they could do it better. They argued that if they were granted control of the White House and the Congress, they would repeal the Affordable Care Act and replace it with something better. We now know that their pledge was pure fiction. They had no plan to replace the ACA with anything. All they wanted to do was repeal.
It is also now clear that President Trump, who as a candidate consistently said that he would fix the health insurance system and make it better, wasn’t telling the truth. In a stunningly callous series of decisions, the President did all he could to deny health insurance for 3 million primarily low and moderate income Americans. And now he is trying to do that to more.
To strip away people’s health insurance coverage with no alternative is indefensible and will cost many more Americans dearly. Without coverage, sick people delay care, which can lead to even more devastating health consequences. And those serious illnesses can cost those individuals and their families their financial security as well.