Soon after the passage of the Affordable Care Act -- quickly dubbed ObamaCare by its opponents -- the number of Americans without health insurance began to drop significantly for the first time in decades. In states that allowed the expansion of Medicaid, such as Arkansas and Kentucky, the rate of uninsured fell by half or more.
For the first time, millions of Americans who had never had access to insurance saw the doors to hospitals and doctors’ offices swing open to them. They got treatment for diabetes, for opioid addiction, for heart problems and other ailments. Lives were saved, lives were improved, pain was eased.
But last year, for the first time since 2010, that trend reversed itself. Despite a strong economy, despite a low unemployment rate, the uninsured rate stopped falling and in fact began to rise. According to Gallup, the uninsured rate among Georgia adults rose by 1.2 percentage points in 2017, which may not sound like much. In human terms, however, that’s roughly 95,000 Georgians who had health insurance in 2016 but lost it in 2017, and that trend shows every sign of accelerating.
Why?
You know why. In 2017, Republicans in control of the White House and Congress lacked the votes, courage and vision needed to “repeal and replace” Obamacare -- they know how to destroy, but not to build -- so ever since that failure they have adopted a less visible strategy of sabotaging the program whenever possible. Through executive orders, rule changes, provisions tucked into must-pass legislation and other tactics, that’s exactly what they’ve done. As Gallup tells us, as studies by the Congressional Budget Office and other nonpartisan experts confirm, that guerrilla campaign against health insurance for Americans is having its desired impact.
The enactment of the Affordable Care Act was revolutionary for another reason as well. For the first time, insurance companies were forbidden by law to deny coverage to those with pre-existing conditions. If you have asthma or diabetes or high cholesterol or cancer, the ACA protects you, ensuring you that your insurance can’t be taken away or priced out of your reach. Poll after poll has shown that to be the most popular provision of ObamaCare.
Now, even that is under quiet attack. In a case in a federal court in Texas, the Trump administration recently filed arguments asking the court to strip protections for those with pre-existing conditions. It claims that changes in the legislation enacted by the Republican Congress have made it unconstitutional to continue to guarantee coverage. In effect, they are trying to achieve through the courts what public opinion prevented them from achieving through Congress.
The legal argument underlying their attempt is highly controversial. In fact, when the decision to intervene came down from the political leadership of the Department of Justice, three career attorneys who had been handling the case asked to withdraw rather than have their names associated with the effort. One of the three even resigned.
Legal experts say that Trump’s attempt to use the courts to gut protections for those with pre-existing conditions is unlikely to succeed, but the federal judge hearing the case is deemed friendly to their cause. Whatever its outcome, the effort is notable as much for the intent that it reveals as for the arguments behind it.
Republicans give lip service to the cause of pre-existing conditions, but compare what they say to what they do. During the 2016 campaign, Trump talked endlessly about a secret plan to provide cheaper and better insurance for all. Compare what he said to what he has done, and vote accordingly.
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