President Trump has derided the Affordable Care Act time and again over the past two years, saying, over and over, that it — and, you would think, it alone — caused insurance premiums to skyrocket.
Here’s the thing: Under Obamacare, health care costs have continued to climb, but (and this is a big but) they have been rising for a very long time — long before Barack Obama became president and long before the ACA became, in the recent words of House Speaker Paul Ryan, the law of the land.
Remember 2009? How could anyone older than, say, 20, forget it? The economy was tanking. Millions of people had lost their jobs. The rich were hocking their precious works of art to make ends meet. The rest of us just laid low and prayed to keep our jobs.
In a September 2009 column, I wrote, “According to the National Coalition on Health Care, the U.S. will spend $2.5 trillion on health care this year alone. Over the past decade, employer-sponsored health insurance premiums increased a whopping 119 percent, and employees saw their share of job-based coverage jump from $1,543 to $3,354 annually. The average employer-sponsored premium for a family of four now costs close to $13,000 a year.
I continued: “‘Health insurance costs are the fastest-growing expense for employers,’ the coalition says. ‘Employer health insurance costs overtook profits in 2008.’”
This was six months before the ACA became law in 2010.
Let’s face it: Our employer-based system of insuring people just stinks, and it has pretty much since it was created in the wake of World War II.
Insurance executives get really rich. The rest of us suffer. Our economy suffers. Yet, as a nation, we appear powerless to change the system.
Obama tried. No, scratch that, Obama did change the system. Nearly 30 million uninsured Americans soon had health insurance — and access to the best medical care in the world.
Now Trump and the Republican-controlled Congress are bent on dismantling Obama’s legacy, starting with the ACA. They want a new system. It’s not entirely clear what it might be. No, sorry, it’s not at all clear.
We know this: Trump tried his darnedest to repeal and replace Obamacare in March. That effort failed, in part because moderate Republicans worried that the so-called American Health Care Act, a.k.a. Trumpcare, would have left 24 million Americans without health insurance, and because it would have allowed insurers to charge higher premiums for people with pre-existing conditions. At the same time, Freedom Caucus members didn’t believe the bill went far enough. They didn’t want to replace Obamacare. They wanted to eviscerate it because, well, they just don’t give a damn. Ryan ultimately pulled the vote when he realized there just wasn’t enough GOP support to pass it.
Then, last month, the House voted to repeal Obamacare — without knowing how the nonpartisan Congressional Budget Office might score its replacement bill. Last week, the CBO released its score — 23 million Americans would lose their insurance.
Now the Senate might put off a vote to repeal and replace the ACA to 2020, according to Bloomberg News.
Is this not insanity?
The New York State Assembly recently passed the New York Health Plan, a bill to create a single-payer system for New York. That is, the state would provide health insurance for all. The Assembly, which is Democratically controlled, had passed similar legislation in 2015 and 2016, but it went nowhere in the Senate, which Republicans control by a one-vote margin.
Now, however, it appears that a single-payer system is gaining traction in the Senate, in large part because state lawmakers are starting to worry that Obamacare might, in fact, be repealed and replaced with some lesser form of a government insurance system, which could leave nearly a million New Yorkers who are insured under the ACA without access to health care.
A single-payer system now has the backing of 30 of 31 Democratic senators — and it was co-sponsored by every member of the Senate’s Independent Democratic Conference, a group of eight Democrats who share power with Republicans, according to the Gotham Gazette, an online politics and policy publication.
Governor Cuomo has yet to take a stance on the New York Health Plan, according to the Gazette. He should. New Yorkers who depend on the ACA need to know that they will be insured no matter what.
The debate over Obamacare boils down to a single argument: Do you believe that access to health care is a right or a privilege? If you believe it’s a right, then you are more likely to favor the ACA. If you believe it’s a privilege that only certain people are entitled to while others are not, then you are likely to oppose the ACA.
It’s comforting to see that a majority of our State Assembly, at least, believes health care is a right.
Scott Brinton is the Herald Community Newspapers’ executive editor and an adjunct professor at the Hofstra University Herbert School of Communication. Comments about this column? SBrinton@liherald.com.