In the ten years since President Obama signed it into law, the Affordable Care Act (ACA) has ushered in unprecedented improvements to our nation’s health care system by expanding affordable coverage to millions of Americans, including those with pre-existing conditions. For those less likely to be insured, like minority and low-income individuals, the ACA has been a much-needed remedy for disparities in coverage.
Today, the ACA is playing its most critical role yet – delivering affordable access to care and providing a critical safety net for millions of Americans during the ongoing health and economic crisis.
While the expansion we’ve seen over the past decade is a reason for optimism, the fact remains that millions of Americans still lack affordable health care – numbers of which are rapidly climbing as millions face unemployment and the loss of their employer-sponsored insurance.
The ACA laid a solid foundation of support for this unprecedented time – now it’s time to improve on it. Unfortunately, the ACA is still under threat from voices on both sides who want to do away with it entirely and completely start over.
One of the biggest benefits of our current system is the power of choice. Thanks to the ACA’s marketplaces, individuals are able to choose a health plan that best suits their needs at a price they can afford. You can compare benefits among providers, choose your doctor and compare out-of-pocket costs. Whether families purchase insurance through ACA exchanges or receive employer-provided coverage, consumers have control over their health care decisions. Proposals like Medicare for All would put that control into the hands of the Trump administration.
If you like your existing coverage, you would not be able to keep it if we eliminated the ACA and installed a federal government-run system. That means that the many millions of Americans with employer-provided insurance would be forced off of their plans. In North Carolina, over 4.6 million people received health insurance through their employers as of 2018.
Not only would Americans have far less control over their health coverage, they would be forced to pay more money for lower quality care. The nonpartisan Congressional Budget Office estimates that Medicare for All would cost taxpayers $32 trillion in additional federal spending in the first 10 years alone. According to some estimates, Medicare for All would require doubling every American’s income taxes or tripling payroll taxes on employers. Hardworking middle class families would be hurt the most.
A government-run system like Medicare for All could also lead to massive job losses. When compared to current projections, studies show that Medicare for All could worsen a shortage in health care professionals, resulting in 44,963 fewer physicians and 1.2 million fewer registered nurses nationwide. That means that patients who need to see a doctor could face long wait times for medical care.
Another study estimates that Medicare for All could eliminate 1.8 million health care jobs such as billing assistants and other medical professionals – jobs that our middle class Americans rely on to survive. Ninety-two percent of these jobs are held by women and over a third of these jobs are held by people of color.
Medicare for All and similar proposals would be especially devastating to North Carolina’s rural communities, where access to care is often in short supply. With rural hospitals already facing closures nationwide, experts warn that a government-run system could result in further closures, especially rural centers that are already struggling to keep their doors open.
The ACA paved the way for millions of Americans to receive affordable health care coverage, but millions more are still in need. As the nation works to defeat and overcome the COVID-19 pandemic, let’s work to protect President Obama and the ACA’s legacy and expand coverage rather than starting over.
Submitted by former State Rep. Jean Farmer-Butterfield