Four words: “established by the states.” According to those wishing to kill the Affordable Care Act—which is in all likelihood the last best chance this country has to put into place what the act claims to do—it is these words will be the “magic bullet” to inflict a mortal wound to Barack Obama’s signature achievement that took almost two years of dedicated work by Democrats in Congress (with nothing but obstruction from Republicans). According to far-right interpreters of the ACA and their media flunkies, this means that premium subsidies can only be provided through state exchanges, rather than the federal exchange.
One suspects that this was an insertion whose original purpose was to garner Republican support, which of course never materialized, and the insertion forgotten—until now. It has always been presumed that the states that did not establish their own exchanges would defer to the federal exchange by default, and in fact many of those Red states have the highest percentage of ACA recipients, given the low-pay, low-benefits nature of their economies; even Republicans and their media stooges assumed the federal exchange role.
Thus I am appalled by the continuing efforts to destroy the Affordable Care Act for apparently purely partisan political reasons, which shows just how out of touch the Right is with simple human decency. They may expectorate about taxes and deficits, but given the deficit-happy Reagan and Bush administrations, this is just a lot of hot air. Such “concerns” have devolved into mere code words for support of the “undeserving,” who in the minds of the Right are allegedly mostly minorities, thus playing on the racial paranoia of their base constituency.
Never does the hypocritical media ask the opponents of the ACA to answer for their lack of simple human decency, and they never tell the truth about what is the “alternative” is, since the ACA is in all likelihood the last best chance to provide affordable health care in this country—just like every other civilized nation. Without it, health care reform in the future will either be impossible, or impossibly expensive to re-enact. As I observed in 2010, the Republican alternative “plan” was “Page Not Found.” More than four years year, it still doesn’t exist.
The strange thing about all of this is that the man and woman on the street who opposes the ACA also seem to believe that health care is a “money” issue alone. Of course it is about money, but it is not about liberal “tax and spend” policies. It really is about affordable health care that may in the short-term cause a budget hit because of the subsidies and more people seeking care that they had put off because of lack of money; but in the long-term it ultimately saves money, because people who would have put off preventative care, seek it instead waiting until far more expensive emergencies develop down the road.
Who pays for no affordable care? In the past, it was those who saw their insurance premiums jump by double-digit percent every six months; I once had an individual plan that went from $170 to $440 a month in two years, despite the fact I had never been to the doctor or needed medical care. The cost of the ACA’s subsidies are far less per person than those outrageous premium increases of the past. But for those on the right, including my dad with whom I’ve had many bitter ideological exchanges of views, it is supposedly about “individual responsibility,” not about inability to afford decent health insurance, or employer failure to provide. What does “individual responsibility” mean to them, exactly? It is just another mostly racial code word.
There is an “easy” way of getting around that: Just say that the states that chose not to establish their own health care exchanges “chose” to allow the federal government to do it for them. I mean, that was the assumption, wasn’t it? How could anyone go about creating the federal exchange with the idea that it was “illegal” in the first place? Nobody thought it was illegal. And what about the media examination of the facts? All it wants to see is disaster, and to hell with people who can’t afford health care and are not provided it by their employers. Instead of allowing evil-minded fanatics from the far-right set the propaganda agenda, why not start attacking their inhumanity? And they are inhuman, more interested in scoring a “victory” against “liberals” than thinking about the welfare of the people as a whole. Why not start attacking them for either not offering an “alternative” still after all these years, or demand them to answer the question of why they believe everyone should not have access to affordable care, especially the poorly-paid in this country.
Who is the “hero” in all of this? A so-called “benefits” lawyer in South Carolina (where else?) who claims that after poring through the thousands of pages of the ACA, he found those four words that would be the “death knell” of the affordable health care. Ooh-wee, pee-pee in his pants over this “discovery” that after five years no one else thought was “significant.” Thomas Christina runs over to the far-right American Enterprise Institute, which euphemistically calls itself a “libertarian” organization, which is a euphemism itself for people who “have theirs” don’t want to burden their “conscience” with taking into consideration the question of inequity in this country.
The problem now is defining what those four little words mean in context. Context is everything. The ACA mandate included the federal program if the states refuse to establish their own. The states may choose to defer to the federal government to establish a health care option for their states. It is thus their choice to have done so, that is what they have established. It is as simple as that. That is how the law has been interpreted by nearly everyone. Yet now here comes this “magic bullet”?
This whole thing is a farce; the problem now, of course, is that the right-wing of the U.S. Supreme Court is so blinded by their hate for common people that the future is as blind to them as the justice they allegedly are bound to serve. The reality is that today less than 60 percent of Americans are covered by employer health insurance, and that number would continue to decrease without the ACA. The number of uninsured would double immediately, and continue to rise afterwards.
And then what? The ACA is the best possible solution we have, save expanding Medicare for everyone. The problem with that, of course, is that prescription will be far more expensive. But who on the Right can ever be accused of being “far-sighted”? People’s lives are nothing but partisan politics to the Right—and to their rich and powerful puppetmasters.