March 11, 2019 | Uncategorized

Protecting and Building Upon the Progress We Have Made

As the debate over America’s health care future continues, this month we also celebrate nine years since the signing of the Affordable Care Act (ACA). The anniversary (March 23rd) provides us with an important opportunity to reflect on the progress made to extend quality, affordable health care to millions of Americans.

That progress – and the opportunity to cover millions more by using the tools available to us under our current system – stands as a strong rebuke to those who advocate eliminating our entire health care system and starting from scratch with a one-size-fits-all government-run program, such as Medicare for All-style proposals that include so-called “buy-in” or a public option as stepping stones to a single-payer system.

Every American deserves access to quality, affordable care – but our current health care system offers a better road map to achieving that goal than those proposals.

Our elected officials should listen to what the American people told them at the ballot box last year: They want to protect and build upon what is working in our current health care system and come together to fix what is broken.

The Progress We Have Made

Today, market-based coverage, such as employer-provided care, works hand in hand with public programs to make quality care available to more Americans than ever before.

The number of Americans who receive health coverage through their employers has increased since the passage of theACA, and now stands at more than 180 million, according to U.S. Census data.  Meanwhile, the array of options within theACA marketplace, Medicaid and Medicare allow individuals who are not covered by their employer to access more affordable coverage that fits their needs and those of their families.

As Kaiser Family Foundation CEO Drew Altman recently noted, “About seven million more people gained employer coverage between 2013 and 2017 – nearly as many as the 10 million people who were covered through the Affordable Care Act’s marketplace last year.”

At the same time, roughly 12 million more Americans have gained access to coverage through Medicaid in the 37 states and the District of Columbia which have expanded the program. The American Medical Association (AMA) notes that data “indicates Medicaid expansion has had a positive impact on patient access and health as well as strengthening the financial stability of safety-net institutions.”

Thanks to the strong partnership between free market and public coverage, roughly nine in 10 Americans are now covered.  Not only that – Americans enjoy greater patient protections than ever before, including for patients with pre-existing conditions and young adults who can stay on their parents’ health plans until they are 26 years old.

It’s no wonder why 80 percent of Americans rate their health care as “excellent” or “good,” according to Gallup.

The Opportunity to Cover Millions More 

Like any system, ours can be improved, and when it comes to bettering American health care, we can all agree there is more work to be done.  Thankfully, our current system provides us with achievable ways to control health care costs and expand coverage to every American.

For instance, by increasing coverage through Medicaid in states that have not yet expanded the program, millions more Americans can have access to care.

By expanding available federal subsidies, Americans at all income levels could choose market-based coverage that works for their families.

And, by using tools such as reinsurance, we can stabilize premiums to control health care costs, providing needed peace of mind for millions of Americans.

Medicare for All-style proposals would take these tools off the table and foist a whole new set of health care problems on theAmerican people:

  • Rather than address the rising cost of health care, these plans simply cut the amount being paid to providers, which would inevitably eliminate competition and reduce choice.
  • Because these plans would dramatically reduce reimbursement rates for physicians and hospitals, there would be a restriction in the amount of care they provide.
  • The costs would be enormous and families would have to pay more.  Two independent analyses’ predict a $32 trillion price tag over 10 years.  As NBC News notes, implementing such a system “requires a massive new source of tax revenue.”

Rather than eliminating our entire health care system and starting over again with a costly, poorly conceived, one-size-fits-all system – as supporters of Medicare for All-style plans would have us do – we should be using the powerful tools within our existing system to move America towards universal coverage.

The American People Favor Protecting What Works, Fixing What Doesn’t

A recent poll by the Kaiser Family Foundation found that most Americans don’t support Medicare for All-style proposals once they learn what it would mean for them.  From eliminating the choice and control Americans enjoy through market-based coverage, to treatment delays and a lower quality of care, to the fact that it would force Americans to pay more, including through higher taxes – Americans are not on board with a one-size-fits-all approach to health care.

In fact, the same poll showed that voters – including most Democratic voters – want Congress to focus instead on protectingand improving upon what works in America’s health care system.

That polling data tracks closely with what voters supported at the ballot box last fall, where the Democratic House candidates who delivered the majority did not run on Medicare for All-style proposals:

  • Of the 11 Democratic candidates who won in House districts where a majority of voters supported Republican presidential candidates in the past decade, not a single one campaigned on support for Medicare for All.
  • Of the House Democrats who won seats in Republican-leaning districts 74 percent did not campaign on support for Medicare for All.
  • Of the four non-incumbent Democrats who won statewide races last November in states President Donald Trump carried in 2016, not one campaigned on support for Medicare for All.

Democrats netted 40 seats in the U.S. House on a platform of protecting and building upon the strengths of our current health care system.  As The New York Times reported last fall, “[c]andidates who delivered the House majority largely hailed from the political center, running on clean-government themes and promises of incremental improvement to the health care system rather than transformational social change.”

As we approach March 23rd and the nine-year anniversary of the signing of the Affordable Care Act, elected officials should take to heart the opportunity to work together to protect and build upon what is working in American health care, while fixing what is broken.


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