Opinion: Health Care Not Yet Settled

by Victoria A. Brownworth

Special to Germantown Newspapers

The U.S. Supreme Court ruled on June 29 that the Affordable Care Act (ACA), commonly referred to as Obamacare, was constitutional. Some thought the decision meant that the debate about the health care overhaul was finished.

Wrong.

Starting with the repeated wrong reporting on the decision by CNN, the spin about the case continued non-stop through Friday’s national newscasts and on into the Sunday political talk shows. Pundits and politicians on both sides of the aisle weighed in. It was, after all, the most anticipated ruling of the SCOTUS session.

It may have been a 5-4 split decision, but as authored by Chief Justice John Roberts, Jr., every aspect of the ACA was deemed constitutional, including the much debated mandate that everyone buy health insurance or be fined.

Polls show that 70 percent of Americans are against the ACA. One of them is Pennsylvania Gov. Tom Corbett (R), who was among the many governors who filed the lawsuit to stop the mandate. Corbett has been silent on the ruling, which is, I think, smart.

Others have not been as savvy. Speaker of the House John Boehner took the court’s ruling as an opportunity to make a stump speech for the Republican Party, reminding people that this was the reason they had to vote President Obama out in November.

As early as Monday, political ads referring to the ACA as a "tax" and "the biggest tax on the American people in U.S. history" began airing in Philadelphia. The ads urged President Obama to overturn the ACA–referred to again as the "tax" and replace it with "patient-centered reform." At one point, the ad shows a worried white couple looking at their bills.

This ad is indicative of how misread and misrepresented the ACA is. And while Obama is being blamed for it, what he really should be blamed for is not explaining it.

Obama took credit for the ruling, yet "Obamacare" could not be more inaptly named. Although roundly considered the signature achievement of his presidency, in actuality, the President did nothing to make the Affordable Care Act happen. In fact, it was his constant capitulation to the then-minority Republican phalanx in the Congress that resulted in the watered-down version of health care reform that was finally passed. And lest the Obama-pologists out there forget, the President was against the mandate–vociferously against it–before he was for it. It was Hillary Clinton who campaigned on the need for a mandate to make health care reform work for everyone.

The ACA is now law. While it may be a water-down version of the 1993 health care reform bill that Hillary Clinton put forward and even a water-down version of the health care reform bill that the Democrats proffered in 2009, the ACA is essential to every American. The mandate that all Americans buy health insurance at the crux of the debate is perhaps the most important element of the entire plan.

It was Chief Justice Roberts’ decision that the mandate was constitutional as a tax that allowed those presenting ads like the ones showing here–Pennsylvania is a swing state with high unemployment–to call it that. But it’s no more a tax than your car insurance. No car insurance, your car gets impounded and you pay to get it out. No health insurance, you pay a fine. Where are the ads against the car insurance mandate?

It’s a simple comparison that President Obama could have made at any point since 2009. But he hasn’t. And when he took his bows in the White House Rose Garden, I once again wished Obama didn’t repeatedly ignore opportunities to fix domestic problems.

Instead of a self-congratulatory moment, what Obama should have done was look directly into the camera–not out into the press pen–and told that 70 percent of Americans who still don’t want health care reform as well as the purveyors of this totally misleading ad why they need it and should be grateful for it.

As with most brilliant social welfare plans in America, health care reform began with Franklin D. Roosevelt. But it didn’t get settled then. Nor did it when Lyndon Johnson, another Democrat with all Americans in mind, pushed through Medicare.

The next president to attempt a health care mandate was Richard Nixon. Alas, his resignation made that impossible. And when Bill Clinton revived the issue, Congress–with Democrats and Republicans in happy collusion–did all they could to annihilate Hillary Clinton and her reform package.

Twenty years passed and now a portion of the original plans of both FDR and Hillary Clinton has become law. Permanent law. The rumblings about rescinding the ACA are merely that–rumblings. The Supreme Court has ruled and as with Roe v. Wade and Brown v. Topeka and other controversial rulings on social issues, other cases may come before the court on this topic, but the court rarely reverses itself. I covered the court for several years in Washington and sat behind that velvet drape in the press box to hear some truly monumental cases. The court doesn’t like to move backward, regardless of whether it leans right or left at a given time. In the 1960s there were signs all over the country that read "Impeach Earl Warren," then-Chief Justice of the Supreme Court because of his rulings on segregation and civil rights. But Warren was never impeached and the court never back-tracked on integration.

Equality is always difficult for some people to handle and that’s what the SCOTUS ruling on ACA was fundamentally about. So fundamental was it, in fact, that even Chief Justice Roberts, who most often votes with the court’s most conservative justices–Antonin Scalia, Clarence Thomas and Samuel Alito–not only voted for its constitutionality, but found a way to explain the mandate.

The failure of the American people to understand the necessity for an overhaul of the health care system and how it is apportioned may be because the President never explained what health care reform was about back in 2009. Instead he allowed the Republican minority to run the table on the discourse and re-frame the entire debate, giving rise to the Tea Party and to the Republican takedown of the Democrats in the 2010 election.

But that was then and this is now. We need to re-frame the discourse in terms of ACA as law. Yet the President still can’t seem to take that step. It would be unseemly to go up to Capitol Hill and slap Speaker Boehner until he shed some of his famous tears, but Obama should do the rhetorical equivalent. He should sit down and talk to the American people from the Oval Office as presidents do from time to time (not Obama, but other presidents) because this is important and worthy of a dedicated discussion between the President and we, the people.

Here’s what we get under the new rules of ACA.

Coverage.

Right now, states have to start complying with the law. Very little of the ACA has kicked in yet, despite having been passed two years ago. But what has gone into play is coverage of kids. Children with pre-existing conditions no longer have to worry about coverage–they have it. It’s difficult to imagine how seven out of ten Americans wouldn’t want that, but that’s what the polls suggest. Perhaps because the President hasn’t taken the time to explain that to everyone. Perhaps because of ads like the ones running in Pennsylvania.

Under ACA sick kids get coverage no matter what. You’d have to be some kind of twisted freak to want sick children to suffer and die, right?

Under ACA all those college kids who haven’t been able to find jobs in this lousy economy get to stay covered under their parents’ health care plans until the age of 26. Again, how could this be wrong? The parents are paying for the family’s insurance. The kids don’t have jobs or jobs with health care because so many employers don’t cover their workers. So when one of those kids is in an accident at work or finds out as happened with the son of a friend of mine that he has cancer, he’ll be covered.

And then there are all those people who couldn’t afford coverage before. About 30 million of them. Medicaid must be expanded by the states to cover the uninsured who are too poor to cover themselves.

In 2014, when the rest of the ACA kicks in, adults with pre-existing conditions will no longer be denied coverage. Women will not pay more than men, as they currently do in one of the most egregiously sexist economic disparities. The elderly will also have more options.

Still grumbling? Still going to the fallback position that this is socialized medicine (if only it were) and that Obama–who had absolutely nothing to do with this health care reform act–is a Socialist? Then do not call the police or the fire department or send your kids to public school or use the library or mail a letter or package because all those services–socialized. Do not collect Medicare, because that actually is socialized medicine.

Yes, government is socialized. But unlike the rest of the civilized world–and some countries we don’t consider civilized, like the ones we are at war with–we don’t have a single payer system that allows coverage for everyone. Mail yes, health care, no. Americans pay more for their health care than any other nation but rank 37th in what they get for it.

The arguments against the ACA all seem beside the point since the SCOTUS decision. How does Mitt Romney propose to overturn the law if elected? How do the Republicans and small group of Democrats in Congress opposed to the law intend to overturn it?

The fact is, only a cruel and mean-spirited minority is talking about overturning ACA and airing the ads making people think covering sick kids–maybe their own sick kids–is a tax. The people working this idea are predominantly rich folks in Congress and their supporters who are already covered by socialized health care with their taxpayer-paid-for health insurance. That 70 percent of Americans against it, I believe, just don’t understand what it is, which is why the President needs to explain it.

No one is immune to illness, accident or old age. We don’t know if we will have a sick parent or a sick child or get sick ourselves. We don’t know if we will get hit by a car or a stray bullet. We don’t know if some genetic or environmental time bomb will go off in our bodies and we’ll end up with cancer or some other disease. I got breast cancer at 26. But I had a good job and good health care. What if I hadn’t?

We all need health insurance because our bodies are the least reliable things in our lives and anything could happen. The ACA is the closest we can come to giving everyone that coverage, so that people don’t suffer or die needlessly. We all benefit from the ACA–us, our parents, our children, our neighbors. Only the irresponsible or irredeemable could be against that.

Follow me on Twitter @VABVOX and follow my political blog at www.victoriabrownworth.com.