Friday, July 25, 2014

All of us have a stake in Obamacare


   It is easy to assume that the people who need Obamacare are not like the vast majority of Americans, not like hard-working, middle-class people who take care of themselves and their own problems. The changes in insurance made in the years since the Affordable Care Act became law make it harder to match that assumption to reality.
    Health insurance would be less available without the federal mandates and subsidies of the Affordable Care Act. That is no longer just a fact of life for the poor, for part-time workers, or for the unemployed. Health exchanges and shifting patterns of insurance coverage have extended Obamacare’s benefits to bankers and brokers and every other American who depends on the shifting circumstances of employment benefits. That includes almost all of us.
    The noise and dust raised by its opponents often obscures the positive impacts Obamacare has had on everyone’s expectations about their health coverage, even if their insurer or their premiums have not changed. Health insurance exchanges, set up by some states and by the federal government in states that were unwilling to provide them, provide a marketplace where anyone can access health insurance options. These exchanges are where Obamacare is most likely to intersect with Americans of all economic circumstances. The stockbroker who loses insurance coverage because his wife is laid off now obtains it through the exchange. The small business that can no longer compete unless it drops insurance benefits does not have to watch valuable employees face life without coverage.
    Consider how much better off the entire population is when no one exceeds lifetime health care limits or discovers they have been denied insurance because of a pre-existing condition or pays more because of their gender. The entire country is better off when its citizens are not a doctor’s diagnosis away from physical and financial disaster, no matter how hard they work or how responsible they have been about saving for the future.
    Democrats ought not assume they must hide from Obamacare. Voters should be skeptical when they hear calls for ending it. All should be afraid of court decisions that would prove fatal.
    The Affordable Care Act is far from perfect. It does not fully address deep flaws in America’s health care system. It has implementation problems. It is, however, fully imbedded in the delivery of medical service to every American, no matter their economic status. It does not just affect others. Obamacare affects us all.




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