Affordable Care Act is not enough

June 29, 2015

Brattleboro Reformer

Last week's Supreme Court decision upholding a provision in the Affordable Care Act (ACA) allowing states using the federal exchanges for health insurance to continue receiving subsidies seems like a major victory on the surface. The real story is much more complicated.

It is a good thing that about 16 million Americans will be able to continue to afford health insurance because of subsidies based on their income. Cutting them off just because a powerful group of Republicans don't like a law and want to punish Obama for being just a little bit compassionate to the more vulnerable among us didn't sway a majority of the Supreme Court.

But the Affordable Care Act is not the kind of health care reform we need to move this country in the right direction. It relies on the free market to dictate too many rules and it relies on insurance companies to dictate premium prices. That means that the law has forced millions of Americans to buy insurance from private companies.

Republicans would want you to believe that the ACA is a government takeover of health care. I wish that it was, but it is really a welfare program for the insurance industry. It has forced Americans to buy insurance or be penalized and it has created an increased market (more profit) for the insurance industry.

If one looks at the history of this law it is clear that it is based on principals first developed by Republicans, chief among them Mitt Romney, whose Massachusetts health plan laid the foundation for the ACA. The problem was that the Republicans decided that this market-based approach to health care reform that they wanted wasn't going to have their name on it.

Obama took the wind out of their sails because he stole their plan and then called it his own. Instead of looking at this as a moment to move closer together politically, the Republican leadership decided to trash their own plan and they have continued to do so with their ridiculous votes to kill the ACA in the House.

The ACA is not the way for Americans to have better health care. Vermont was on the verge of using the ACA exchanges as a stepping stone to single payer but Governor Shumlin bailed as soon as the going got tough. There was great hope for moving past the ACA in Vermont so we now have to regroup and figure out how to work toward meaningful reform.

The ACA also took the wind out of the sails of the more liberal groups working on health care reform in this country. Many organizations who were trying to move beyond the ACA to single payer or, to a more government controlled system, started to lose their funding as the ACA was starting to be implemented.

Foundations and individuals were duped into thinking that this country actually had enacted real health care reform and that their mission for reform was now over. Many major health care reform funders stopped giving out grants to fund grassroots reform efforts and instead put their money into ACA implementation and into supporting state and federal exchanges.

As a result of losing this kind of funding, many organizations either went out of business or are struggling to exist by scaling back health care reform efforts. In other words, too many Americans believed that it was mission accomplished when the ACA was implemented.

The ACA means that there will be very little control on the rising cost of health care and that insurance company profits will continue to soar. Subsidies will help some, but subsidies are simply taxpayer money shuffled into insurance company piggybanks.

Too many of the American people do not understand what the recent Supreme Court decision did to their pocketbooks. Insurance company subsidies will continue so taxpayers will have to keep paying more and more to fund a program that should be saving money for them instead of providing financial security for the health insurance industry.

As long as the ACA is the health insurance standard in this country we will never see a day when health care is accessible and affordable for all Americans.

Richard Davis is a registered nurse. He writes from Guilford and welcomes comments at