If Republican politicians want credibility on health care they should dispense with the fabrications and exaggerations because Americans deserve decisions rooted in reality.
In recent days, we’ve heard Gov. Matt Bevin claim that the Affordable Care Act has “resulted in a remarkable decline in health care coverage” and “fewer people able to actually even see a doctor.” What’s remarkable is how wrong he is.
The ACA enabled 22 million Americans to gain access to preventive care. Americans without health insurance declined from 13 percent to 9 percent of the population. The improvement was even more dramatic in Kentucky as the uninsured rate dropped from 15 percent to 6 percent. A raft of research shows that more Kentuckians are obtaining preventive medical care, disease screening and treatment for substance abuse because of the ACA.
But Trump, who campaigned on a promise that no one would lose coverage, won the trophy for most detached from reality when he told the nation’s governors, “Nobody knew that health care could be so complicated.”
Senate Majority Leader Mitch McConnell’s favorite ACA descriptors are “disaster” and “brink of collapse.” In Louisville last month, McConnell admitted that he had never before that day heard from a Kentucky businessperson who likes the ACA. The owner of an IT consulting firm, who has leukemia, told McConnell that the law has helped him and his employees. Perhaps McConnell really is wrapped in a partisan cocoon so tight that he’s unaware that a half-million of his constituents have access to health care because of the law he reviles.
More likely, McConnell knows how good the ACA has been for Americans, especially Kentuckians, and hopes to avoid political disaster for his party by repeating “disaster” and “collapse” until people are convinced. It’s a reasonable bet. A third of Americans still do not know the ACA and Obamacare are the same.
Something else a lot of people don’t know: Repealing the ACA, as Trump, McConnell and a House Republican plan propose, would give the richest Americans a big tax cut, while raising taxes on may lower income families as their insurance tax credits end.
Also, the economics of ACA repeal are so sketchy that House Republicans may move a bill in committee without an analysis by the Congressional Budget Office, which means the committee would vote without knowing the costs or how many people would be affected.
No one ever touted the ACA as health-care reform’s ultimate destination. It has put us on a better path. Coverage, whether through private insurance or Medicaid, does not by itself guarantee better health outcomes. Bevin is right about that. But coverage is the necessary foundation for achieving better outcomes. Instead of turning back the clock to pre-ACA days, as Sen. Rand Paul would do, Congress should keep moving us toward a healthier nation at a more reasonable cost.
Republicans have painted themselves into a corner with their rabid rhetoric on a law that’s market-based and, while imperfect, is helping a lot of people. Republicans can help themselves by starting to talk realistically about what’s at stake.