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As
the coronavirus pandemic continues to wreak havoc on people’s
lives, President Joe Biden has been on a victory tour to promote the
American Rescue Plan, a hefty $1.9 trillion spending package that not
only sends direct stimulus payments to struggling Americans, but also
greatly expands health care options through the Affordable Care Act
(ACA). “We’re becoming a nation where health care is a
right and not for the privileged few,” said Biden
in his remarks
at a hospital on the campus of Ohio State University. Eleven years
after the ACA was first passed into law as President Barack Obama’s
signature health care reform, it has survived relentless Republican
attacks in the form of legal
challenges
and defunding
attempts.
Preserving and expanding it under Democratic leadership certainly
constitutes a win against Republican obstructionism and a refusal to
offer better alternatives. But this latest strengthening of the ACA
is first and foremost a victory for the health insurance industry.
The
American Rescue Plan includes tens of billions of taxpayer dollars to
substantially lower premiums for insurance options purchased through
the ACA health exchanges. Additionally, it covers
100 percent of the cost of COBRA coverage
for those who have been laid off during the pandemic. Even the New
York Times
characterized it with the headline, “Private Insurance Wins in
Democrats’ First Try at Expanding Health Coverage.”
Dr.
Paul Song, co-chair of the Campaign for a Healthy California, and
board member of Physicians for a National Health Program, explained
to me in an interview
that, “that’s money that’s just going to the
private insurance industry.” He asked, “why not say to
anyone who lost their job during the pandemic and lost their health
care coverage, that you would automatically be enrolled in Medicare
until you found your new job?” Such a move would cost
significantly fewer taxpayer dollars but would have boosted the
arguments in favor of a Medicare for All program, which centrist
Democrats
like Biden
have vehemently railed against for years. Ironically, insurance
industry loyalists cite high costs as central to their opposition to
Medicare for All.
A
new
poll
by Morning
Consult
and Politico
finds that a majority of Americans - 55 percent - support Medicare
for All. Strangely, the pollsters headlined their results by saying,
“Medicare for All Remains Polarizing.” Nearly 80 percent
of all Democrats support it, and even among Republicans, more than a
quarter back the idea of a government-run health plan for all.
As
Biden touts the success of the ACA (without mentioning the high cost
of supporting it), a growing number of Democratic lawmakers are
refusing to fall in line. Congresswoman
Pramila Jayapal
(D-WA) dismissed
the health care subsidies in the American Rescue Plan, saying, “I
don’t think this was the most efficient way to do this,”
and had instead called for exactly what Song suggested: that
unemployed Americans sign on to a Medicare plan rather than their
former employer’s plan.
Jayapal
recently introduced
the Medicare for All Act of 2021, which was co-sponsored by more than
half the House Democratic Caucus. Her office released a statement
explaining that the bill “guarantees health care to everyone as
a human right by providing comprehensive benefits including primary
care, vision, dental, prescription drugs, mental health, long-term
services and supports, reproductive health care, and more with no
copays, private insurance premiums, deductibles, or other
cost-sharing.”
Dr.
Song is hopeful, saying there is “more momentum every year”
for such a program. Whereas in previous years Democrats like former
Congressman Joe Crowley would have railed against Medicare for All,
“they’ve all been voted out by the AOCs, by the Jamaal
Bowmans,” said Song, referring to the freshmen representatives
from New York who in recent years ousted centrist incumbents like
Crowley from their party in primary challenges. Now, “for the
first time, the entire New York delegation has supported Medicare for
All,” he said.
The
timing for a bold and comprehensive health care plan is ideal.
According to Axios,
Biden “loves the growing narrative that he’s bolder and
bigger-thinking than President Obama.” Democrats are looking to
distinguish themselves from Republicans in willingly spending what it
takes to care for a population battered by the pandemic after years
of austerity measures that have whittled away safety net programs.
Criticism of Medicare for All from a cost perspective will not only
be deemed hypocritical, but it will also sound Republican-like in its
callous calculation to prioritize private interests ahead of human
needs.
According
to the advocacy group Public
Citizen,
the U.S.’s private health insurance-based system put the nation
at such a deep disadvantage during the pandemic that according to a
new analysis, “millions of Americans have contracted COVID-19
unnecessarily and hundreds of thousands of deaths could have been
prevented.” This estimate is not based on people dying because
they did not have health insurance. On the contrary, the government
rightly stepped up to ensure that COVID-19 related treatments for the
uninsured would
be covered by taxpayers
(yet more proof that lawmakers are willing to cover everyone’s
health care costs if the crisis is dire).
Rather,
Public
Citizen
found that our entire health care infrastructure failed because
“hospitals focused on profit and revenue were unable to respond
to COVID-19 while safety net hospitals faced closure.” The
patchwork of private health insurance systems and limited public
systems left the nation in a confusing mess at a time when
streamlined approaches to a deadly pandemic required systematic
testing, contact tracing, and now, vaccine distribution. In contrast,
as per Public
Citizen,
“Countries that had more unified systems were better able to
roll out testing, track the spread of the disease via a central
information hub, and intervene appropriately.”
Given
the fact that Democrats require either some Republican support or an
end to the Senate’s filibuster rule in order to pass any major
legislation, Jayapal’s bill is likely to remain aspirational.
However, newly seated Health and Human Services Secretary Xavier
Becerra may be able to offer another pathway to a government-run
health system. Backers of such a system ought to take heart from
Becerra’s
confirmation
hearing where the likes of Republican Senator Mike Crapo (R-Idaho)
said to him, “Your long-standing support for single-payer,
government-run health care seems hostile to our current system from
my perspective.” Of course, Becerra said what he had to in
order to win confirmation and toed the Democratic party line by
responding that he would be enacting President Biden’s agenda,
not his own.
Still,
according to Dr. Song, “Secretary Becerra has been very public
in saying that he thinks states should be afforded waivers, and now
he has the ability to do that.” One of the positive aspects of
the ACA is that states have the right to apply for federal
waivers
and that the HHS secretary oversees the granting of such waivers.
According to The
New York Times,
“Because these waivers do not require congressional approval,
they could become a crucial policymaking tool for the Biden
administration,” regardless of which party controls the Senate.
“States
like California could set up their own state-based health care system
if it at least met the standards determined by the ACA,”
explained Song. Just like their federal-level centrist Democratic
counterparts, California Governor Gavin
Newsom
(and before him, Jerry
Brown)
spoke out in favor of Medicare for All while they were candidates
only to back off from taking a strong stand on the issue once they
had the power to do something about it. Newsom,
who is facing a Republican-led recall effort, is now facing a push
from his Democratic colleagues in California’s legislature to
keep his promise on health care.
Regardless
of how we arrive at a government-run health care plan, there is
growing momentum for it. Scientists worry that the next
pandemic
is just around the corner. Instead of throwing taxpayer dollars into
the pockets of private health insurance industry executives, a
government-run plan would not only be more efficient and cheaper but
also save lives - which is ultimately what should be the most
important consideration.
This
article was produced by Economy
for All,
a
project of the Independent Media Institute.
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