Almost seven years after its passage, the Affordable Care Act has been perhaps the most contentious piece of legislation that most people under 40 have seen in their lifetimes. The battle over what has been dubbed President Obama’s legacy has officially begun today on Capitol Hill. Republicans, headed by Vice President-Elect Mike Pence, are cloistered on one side of the building drawing up the game plan for how to unilaterally remove this statute. It has been a target of Republican ire since its inception, and since the elephant stampede of the 2010 midterm elections they have attempted to pass legislation to defund or eliminate the ACA more than sixty times. For the last six years this has been nothing more than political pandering, with an absurd amount of time dedicated to an action that was impossible during Obama’s presidency. Once again we are preparing for a political tug of war that will only serve to give the American people a bad case of rope burn.
On the other side of the building on the exact same day, the Democrats, led by President Obama, are lining up the Xs and Os of their best prevent defense. The Democrats are likely about to pay the price for their unilateral legislative action seven years ago. Democrats passed the ACA, ironically modelled after a plan previously developed and passed in 2006 by then Republican Governor Romney in Massachusetts, without one Republican vote in either the House or the Senate. Being more concerned about putting the Healthcare Reform trophy in the case by any means, will perhaps be the undoing of the single largest healthcare bill passed since the 1965 passage of Medicare.
We have had serious problems in healthcare in the United States for two decades, First Lady Hillary Clinton attempted to make a mark with healthcare reform in the mid-1990s, and yet we allowed our representatives to squabble over partisan procedure and ego, wasting years of time. The United States does offer some of the best healthcare in the world; wealthy families from around the world routinely seek out our facilities for their procedures. In direct contrast to that, access to healthcare by U.S. citizens has been on the decline for a variety of reasons, but primarily as a result of the increasing cost of care and the availability of medical insurance, long seen as a necessity for access to care in the United States.
At the onset of the ACA, the CDC has reported that 15-16% of Americans did not have any type of health insurance. Since the passage of the ACA that number has been reduced to 9.20% in 2015. The problem that we face is that health insurance premiums (the cost to purchase the plan typically paid in part by a person’s employer and/or the individual) have risen much faster than income and the cost of inflation.
So back to our current situation, we have a number of complicating issues with healthcare in the United States and neither party has been particularly effective at resolving more than one of them at a time. Albert Einstein is attributed with saying “Insanity is doing the same thing over and over and expecting different results” and that is exactly what we are seeing. A one-party majority in both houses, with a president-elect absolutely despised by the other side of the aisle is trying to figure out how they can enforce their will on the other side. Eerily reminiscent of 2009 and 2010, and quite likely to be repeated in a few more years when the pendulum swings the other way.
As voters, we need to stop letting politicians direct the narrative on this issue, and start telling our representatives what we want them to do beyond “block the other side”. The Democrats have a legitimate issue in pointing out that our system leaves way too many people behind, and that almost every other developed nation in the world has come up with a better solution to serve their populace than we have in the U.S. Republicans are also correct in pointing out that the ACA has done absolutely nothing to contain skyrocketing costs, as well as the fact that there are some significant limitations to many of the socialized medicine plans available in other countries.
Our current trajectory is not sustainable. We need to demand that our lawmakers put their egos in the corner and start working on a solution that is more functional than what we have and one that is not going to immediately be dismantled the next time an election shifts power the other way. We need to care more about fixing the problem than we do about winning the argument.