After 7 years of Republican promises to do away with the Affordable Care Act (ACA) (Obamacare), the moment to do it came and went without success. It is proving difficult to do away with an idea that had been percolating since the time of Theodore Roosevelt (a Republican) and his campaign for president in 1912 that was in part supported by progressive health care reformers wanting to put in place a national system like the one we have.
For the next 96 years a number of national leaders including sitting presidents of the United States tried to bring the idea to fruition without success. It was left to President Obama, a leader that represents a racial departure from the normal order, to make a successful attempt.
As a result, the Conservative leadership especially in the Red states and nationally were faced with three problems with a program the nation had been wanting for a century. First, given that currently we are a very divided country and the fact that it was the other party that got it done, the political bitterness created by the process has festered.
It did not help that the Democrats went at it alone in developing the legislation. Second, the Conservative political apparatus is very suspicious of programs that increase taxes and regiment private sector participation.
Third, the ACA was done under the leadership of Barack Obama, a Black American President from a race that is still marginalized especially in the South where the Republican Party is the strongest. You have only to see and hear the followers of Trump’s campaign and presidency to know that we still have a long way to go to heal the racial divide.
Recently, Republicans in Congress took a page from the Democrat playbook on health care and excluded the other side from the deliberations leading to the vote to repeal and replace the ACA. They also chose to shorten drastically the deliberative process as well as provided a hurried-up legislation with less thought and reduced support in the party.
The future of health care insurance is cloudy as ACA does have major issues that need to be addressed. The President is also signaling that he wants to diminish the program and can eliminate the administration’s Cost-Sharing Reduction (CSR) payments to insurance companies that help to defray the cost of coverage for lower income Americans which would force more insurers to withdraw from the market.
One thing is sure however; the majority of families in this country have tasted the makings of a universal health care system and are increasingly deciding that despite all of the shortcomings, they want to keep it. Also, the longer the ACA continues, the more support it will garner.
The current system is a public-private partnership where the government provides the rules of implementation as well as tax support for premiums to help the most needy and an insurance industry that offers a range of options within the law. The repeal and replace movement has not sought to alter that concept.
What it does propose is to change some of the rules for coverage and lessens drastically the government tax support for the program. It also wants to do away with the “Obamacare” reference and replace it with something that makes a different political statement.
The growing majority of Americans that support universal health care are not concerned with legislation titles or who takes credit for what. They just want to keep and improve what they have.