Blair Horner: A Milestone In Helping The Uninsured

Apr 7, 2014

The nation hit a milestone last week:  the deadline for signing up for coverage provided by the Affordable Care Act.  Despite an unbelievable torrent of mistakes, criticisms, deceptive ads, and outright lies (remember the claims of so-called “death panels”?), enrollment in newly-created health marketplaces hit an estimated 7 million enrollees – the goal set by the Administration last June.

In addition, an estimated 3 million uninsured got coverage through an expanded Medicaid program – which provides insurance for the poor.  And 3 million young adults obtained insurance through their families’ coverage, due to the option of covering young adults up to the age of 26.

The Obama Administration lost an important two months this Fall when the federal website offering health insurance crashed.  Critics immediately leaped on the failure, pummeling the Administration and arguing that it was clear evidence of the federal government’s inability to handle complex services – and thus bolster their calls for savaging it and other public programs.

Lost in all of this toxic debate was the reason for the program in the first place: as many as 50 million Americans – in many cases our neighbors and friends – were without health insurance.  Not only was that a national disgrace, it meant more serious illnesses, bankruptcies, and early deaths for those without coverage.

So the Obama Administration pulled off something that had eluded Presidents for decades – a near universal program to provide health insurance primarily for those between the ages of 18 and 65.  Reasonable people can differ on whether the program is the best way to provide coverage, but it is unreasonable not to do something about the health scourge resulting from lack of insurance.

And opponents never offered anything except attacks.  Attacks that were increasingly shrill and unhinged from the reality of the program.  Like auto insurance, all the Affordable Care Act requires is that people without government or employer sponsored health insurance have to buy it.  If you are middle income or less, the government would provide subsidies to help you pay for it.

Nothing sinister about that.  In fact, the state of Massachusetts did something similar and now 98 percent of its residents have coverage.

New York State has its own health marketplace.  Created by Governor Cuomo, the state has made remarkable progress in offering coverage with over 800,000 New Yorkers now getting coverage through the state’s health exchange, plus thousands more are covered through Medicaid.  As part of this year’s budget agreement, the governor was successful in getting recalcitrant Senate Republicans in agreeing to a budget that funded the program for another year.

Good news right?  The percentage of Americans without health insurance has dropped from more than 20% in the Fall to about 15% today.  The program has provided the single biggest expansion of health insurance coverage since the establishment of Medicare and Medicaid in the 1960s.

But opponents still keep up their attacks in order to keep up the perception that the Affordable Care Act is a failure – even if it’s not.

But why?  Obviously there are some who are opposed on policy grounds.  They think that the nation could offer coverage through other mechanisms.  Fair enough.  But for those who smear the program, what do they want?

They appear to be putting their own ideological or political priorities ahead of the needs of tens of millions of Americans.  People who need help, a safety net to protect them, both financially and medically.

Such callous indifference to the needs of real people is one of the reasons why people feel so disgusted with American politics.  Yet, tuning out of the debate only ensures that those who are most cynical will prevail.

Let’s not get caught up in the false debates.  Let’s remember that this is what government is supposed to do – help people in need.

Blair Horner is the Legislative Director of the New York Public Interest Research Group.

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