In the face of rising premiums, Republicans are again piling on the Affordable Care Act, calling for repeal and replacement. The problem, of course, is that they can’t agree on any replacement — never have been able to, even under a Republican president and control of Congress. Their “replacement” strategy is to throw 20M people off the health care rolls and avert their eyes.
Two things primarily are wrong with the Affordable Care Act. One is that Republicans gutted the provision that made health insurance mandatory — just like car insurance is mandatory for anyone who wants to get behind the wheel of a vehicle. Insurance works when most people sign up. We all pay in, and we can benefit if we have an accident or health crisis. Some of us never do; we pay in without taking out. That’s fine with me. I wouldn’t want to be sick or in a car crash, just so I could file a claim.
The other problem is that the people newly covered are sicker than expected. With some sort of perverse logic, Republicans think the solution is to throw them out of the health care tent. Finding that a large pool of Americans are sicker than we thought means, to me, that we need a whole lot more health education and preventative care. We need to encourage people to lose weight, stop smoking and drinking to oblivion, exercise more, and get off the opioids.
The problems of the Affordable Care Act are fixable, with any sense of human decency and a modicum of bi-partisanship in Congress. Will we get it post-November 8th? Maybe, if enough of us are disgusted by the hyper-partisanship that now prevails.