Fifty-three percent of Americans view the Affordable Care Act (ACA) “favorably”, an “all-time high” (Kaiser Family Foundation poll, September 13, 2019). Why? The ACA extended comprehensive quality health coverage to over 22 million through ACA affordable private insurance (covers 193,303 Wisconsinites), Medicaid expansion and allowing young adults (under 26) to be covered through their parents’ insurance. And, the ACA guarantees coverage to 52 million, including 852,000 Wisconsinites, with preexisting conditions (Kaiser). Moreover, the ACA lowered out-of-pocket drug costs for Medicare enrollees. Finally, the ACA reduced uncompensated care, helping both rural and urban hospitals.
However, Trump continues to sabotage the ACA by making it harder to enroll in ACA private insurance: cutting the open enrollment period by half, nearly eliminating advertising, slashing funding for enrollment assistance, ending federal cost-sharing payments and allowing the sale of worthless “junk insurance”. Moreover, Trump is trying to have the ACA declared unconstitutional through a federal lawsuit orchestrated by former Governor Scott Walker. A decision may come soon. And, if all else fails, Trump is counting on being reelected in 2020 with a GOP-led Congress to repeal the ACA.
No surprise then that fewer Americans are insured: “About 27.5 million people, or 8.5 percent of the population lacked health insurance for all of 2018, up from 7.9 percent the year before, the Census Bureau reported … (Wisconsin’s ACA coverage declined from 235,444 in 2017 to 193,303 currently). It was the first (national) increase since the (ACA) took full effect in 2014, and experts said it was at least partly the result of the Trump administration’s efforts to undermine the law” (New York Times).
However, not all Republicans have their heads in the sand. 38 states, including 16 GOP-led, have (3 in process) Medicaid expansion. Many in the GOP recognize that ACA Medicaid expansion helps mightily: reduces the uninsured and uncompensated care, keeps rural hospitals open, increases access to treat opioid misuse and substitutes federal for state expenditures, providing jobs and producing savings for roads, transit and schools. In Mississippi, former state Chief Supreme Court Justice Bill Waller ran for the GOP gubernatorial nomination supporting Medicaid expansion. He lost in a run-off, but state voters can now vote for Democratic gubernatorial candidate Jim Hood who supports expanding Medicaid, as does Republican Delbert Hosemann, running for lieutenant governor.
Some Wisconsin Republicans get it. GOP state Senator Luther Olsen said: “I honestly think we have to take it (Medicaid expansion federal funding). Whether we do or not, I don’t know. We need to look with an open mind what it does for the state of Wisconsin” (2019). And, GOP state Senator Jerry Petrowski said: “I believe that we could have taken the (Medicaid expansion) money, however I could not find enough votes to get it done” (2014). Wisconsin voters should encourage GOP legislators to do right: ring the Madison Capitol Square with posters of GOP governors and legislators from around the nation on why they supported Medicaid expansion for their states.
And, vote! Health care is on the line.
– Kaplan wrote a guest column from Washington, D.C. for the Wisconsin State Journal from 1995 – 2009.