Lives Remain In the Balance: 2019

Submitted to the AFRO by Congressman Elijah Cummings

If President Trump and his Republican allies would seriously consider both their sense of humanity and the lessons of history, they would halt their continuing attacks on the Affordable Care Act (the “ACA” or “ObamaCare”) and work with Democrats to solve the health care challenges that our nation faces.

As Congressional Black Caucus Chairwoman Karen Bass of California recently observed, Americans – and, especially, African Americans – will be seriously harmed if the opponents succeed in destroying the ACA.

A humane nation can not allow that carnage – as the lessons of recent history illustrate.

During the current national debate about health care, it is important to recall that, before the ACA, nearly 50 million Americans lacked health insurance<https://www.nytimes.com/2017/05/22/health/obamacare-health-insurance-numbers-nchs.html>, and nearly 10 million of these uninsured were African American.  Women were charged more than men for the same care, and insurers could drop coverage, deny coverage, or charge 130 million Americans with pre-existing conditions more for their care.

Chairwoman Bass is also correct in concluding that, on balance, the ACA has been a success.

In the neighborhood of 20 million more Americans, including millions of African Americans, now have access to quality affordable healthcare.  Children can remain on their parents’ insurance until the age of 26 – and, perhaps most important of all, health insurance companies can no longer drop or deny care due to a pre-existing condition.

This is not to say, however, that we have solved all the obstacles to assuring that Americans can afford the health care that we all need and deserve.  We have yet to adequately control price-gouging in the cost of our prescription drugs – and insurance premiums continue to rise at an unacceptable rate.

My colleagues and I have advanced legislation that would reduce the price-gauging by BIG PHARMA – and reforms are possible that would moderate premium increases.

For example, in my State of Maryland, insurers who originally sought premium increases for 2019 have decreased their premiums because of a state “reinsurance” plan that helps the insurers cover unusually expensive health care claims.

The President and his Republican allies should take note.  If they would consider these reforms in the context of the history of this national debate, they would recall that two major forces catalyzed the health care reform process more than a decade ago.

First, even before President Obama and congressional Democrats began the process that resulted in the Patient Protection and Affordable Care Act, the National Institute of Medicine concluded that more than 18,000 Americans were dying prematurely every year because they lacked health insurance, while research from Harvard estimated the number of premature deaths at 55,000.

That avoidable annual death toll was and remains an unacceptable human cost, challenging our basic humanity as a civilized people.

History also reminds us that a second motivation for reform was the accelerating increase in healthcare costs that threatened the budgets of governments, businesses and individual households alike.

The private, largely for-profit insurance system in this country was failing to fully address these challenges a decade ago – and it continues to fail these tests today.

These considerations are why the President and Congress alike must provide the American People with the answer to a fundamental question.

Why should we continue to provide massive public subsidies to a failed system of healthcare financing when it could be more cost-effective and rational to fund healthcare for everyone in the same manner that we already fund health care for our elderly, disabled, veterans, and poor?

The answer to this question is why some of us believed a decade ago (and continue to believe today) that a single-payer system based upon expanding Medicare to everyone would be the most effective strategy.

However, as has always been the case, politics remains the art of what is possible, even if the possible is less than ideal.

Establishing access to affordable healthcare as a civil right through the Affordable Care Act was the progress that we could achieve politically back in 2010 – and the ACA remains our first line of defense today.

That is why I have joined more than 120 of my Democratic House colleagues in co-sponsoring The Protecting Pre-Existing Conditions & Making Health Care More Affordable Act of 2019 [H.R. 1884], proposed reform legislation introduced by Energy and Commerce Chairman Frank Pallone, Jr., along with Education and Labor Chairman Bobby Scott and Ways and Means Chairman Richard Neal.

If enacted, our bill would strengthen protections for people with pre-existing conditions and reverse the Trump Administration’s efforts to sabotage the ACA.

We would make health care more affordable by lowering health insurance premiums for low- and moderate-income Americans by expanding eligibility for premium tax credits beyond 400 percent of the federal poverty line and increasing the size of tax credits for all income brackets.

Finally, following the course charted by Maryland’s Legislature and other states, our legislation would create a national reinsurance program to help cover the costs of consumers with expensive medical conditions, thereby lowering health insurance premiums for everyone.

Lives remain in the balance, and the choice for the President and Congress is clear.
We can do what is both practical and humane to assure affordable health care for everyone – or we will pay for our failure to do so in hemorrhaging budgets and lost American lives. Congressman Elijah Cummings represents Maryland’s 7th Congressional District in the United States House of Representatives.

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