One of the strangest things about the debate surrounding the Affordable Care Act (ACA) — the health care law passed under President Obama — is the narrative that the ACA is some sort of Socialist, government takeover of the health care system.  In reality, it is a system that draws on market-based ideas.  The irony is that the idea behind the ACA is actually a conservative-minded approach because, done correctly, it keeps health care in the hands of the people rather than as a handout by the government — and we all know how much Republicans hate handing out ANYTHING to people.  : )   And, by the way, for those worried that our health care system is getting more "Socialist," that ship has sailed.  We already have single-payer systems called Medicare, Medicaid, and the Veterans’ Administration.

​

The center of the original ACA was competition which, in theory, should keep costs low and the level of service high. To this end, the ACA established government-run marketplaces, or "exchanges."  Other hallmarks of the original ACA included Medicaid expansion (or government-provided health care for those in poverty) and limited discrimination (i.e. insurers must accept all applicants, regardless of their health or other factors such as the applicant's sex, pre-existing conditions, or occupation).

​

To be sure, the final version of the Affordable Care Act ended up being a complex hodgepodge of private insurance and government-funded care, and there are many, MANY ways it needs to be improved (read more here).  But that's what we need to do.  Starting from scratch is just silly — Republicans obviously have no idea where to even start, and the alternatives being pushed by Democrats are just too expensive and unrealistic (read more here). 

 

We have the architecture of something — let's make it the very best we can!

​

Unfortunately, thanks to the Trump administration and Republicans, we have way more work to do than we did three years ago.  For the final two years of President Obama's presidency, Republicans had a solid platform to outline their solutions for the nation’s health care challenge, and after Donald Trump's election to the presidency, their power became absolute.  Even with a vast amount of time and influence available to them, Republicans were unable to craft an intelligent health care agenda.  So instead, they played to the lowest common denominator of their base and decided to just sabotage the ACA. 

 

The reason is unclear — literally the only reason we can think of is that Obama's name is attached to it.  What a super mature response!

​

Certainly, the ACA has issues — which we work really hard to resolve here — but the Republicans petty, lazy sabotage efforts have exacerbated the challenges big time.  Their efforts include canceling the individual mandate that requires people to obtain health insurance or incur penalties; blocking reimbursements to insurers who sell ACA health plans; establishing new rules that allow states to opt-out of the ACA's most important provisions; cutting the open enrollment period in half; limiting the operating hours of HealthCare.gov, the enrollment platform; slashing funding for Navigators, individuals or organization that are trained to help consumers, small businesses, and their employees look for health coverage and complete eligibility/enrollment forms; and killing an outreach program that helps people sign up for health insurance.

​

This snake oil, smoke and mirrors, sideshow approach to governing is absurd.  Obviously, they have no idea how to solve this challenge.  So, to substitute for substance and compensate for incompetence, they reduce complex issues to inflammatory dogma, confident that we will once again settle for the lesser of the two evils.  We must move past this ridiculousness. ​