Affordable Care Act, Barack Obama — June 18, 2016 at 10:01 am

REMINDER: This election is also about whether millions gain health insurance or tens of millions will lose it


Medicaid expansion and the ending of discrimination against people with pre-existing conditions are the greatest victories for working Americans in generations


Rejoice, fellow Americans who don’t enjoying seeing your fellow Americans die of indifference! More than 200,000 Louisianians will have health insurance on July 1 because the state elected a Democratic governor last year.

And this could just be the beginning of the good news for Medicaid expansion, the aspect of Obamacare that most directly takes on income inequality by taxing the well-off a bit to get the working poor basic health coverage.

“If it becomes obvious the Affordable Care Act won’t be repealed, a number of states will opt into the expansion fairly quickly,” Louisiana’s new governor John Edwards told Modern Healthcare.

The case to conservatives will be simple in 2017 — it’s the same case that persuaded Republicans in Michigan not to make the insane decision to turn down free coverage for some of the state’s hardest working families.

“Edwards said he and his team overcame the resistance of the state’s Republican-controlled Legislature by stressing that the Medicaid expansion was funded by dollars Louisiana already was paying and that were going to other states.”

Continuing to expand Medicaid — especially in the three states with some of the highest uninsured rates who are paying for coverage and refusing to expand it, Texas, Florida and Georgia — is the most obvious way to cover millions in the next year. Because it doesn’t need Congress to act to make it happen. We need to do much more, but it’s a start.

A rational nation would look at the chart below, which shows the uninsured rate sinking to the lowest numbers ever recorded, and ask, “How do we insure that last 10-11 percent, knowing that every country in the first world insures all their citizens and does it much more cheaply than we do?”


This election should be about the best ways expand coverage. But it’s not.

Obamacare’s success — like the success of Social Security, Medicare and Medicaid — is undeniable. So conservatives must deny it and destroy it.

Next week, House Republicans will propose the broad outline of an “Obamacare replacement” so vague it can’t be scored so we won’t know how many people would lose coverage under it. But you can be certain that millions — possibly tens of millions — of the 24 million who’ve gained coverage will lose it.

Some of the big conservative ideas you can expect to see in the plan — according to The Huffington Post’s Jonathan Cohn and Jeffrey Young — are:

Make the sick pay more

Make Medicaid better by shrinking it

Turn Medicare into a voucher program

Smaller subsidies for fewer people

Coverage for (some) people with pre-existing conditions

The last one is the most offensive.

The greatest achievement of Obamacare is that it ended discrimination against ALL people with pre-existing conditions. It did it in a wonky way that used conservative ideas and we would be better off with single payer. But it did it in the way that was possible. Most importantly, it did it.

Punishing people for people for having ever been sick is punishing them for being human. Encouraging people to avoid getting help by promising them that any diagnosis will haunt them for the rest of their lives is just wrong. And it’s ultimately a stupid thing to do knowing that anyone who gets old or sick enough ends up needing government assistance anyway.

This is election isn’t about which way we move forward. It’s about whether we should pull the emergency brake in the fast lane and let our poorest sickest people clean up the wreckage.

Yes, this election is mostly about whether a petty tyrant with the morals of a rotting peach gets the nuclear codes. But this is just another small way this election is the most important of our lifetime.

[CC photo by Will O’Neill | Flickr]