There is a man in Tacoma right now who is wondering what will become of his health insurance.
His name is Nick, and he is a paraeducator for special-needs students at Tacoma Public Schools. As it is, he’s scraping by on the small salary the job offers, and he can’t afford the premiums on the insurance offered through his employer. So he relies on subsidized health care offered through the Washington Health Exchange, both of which—the subsidies and the exchange—were created by the Affordable Care Act of 2010.
When President Barack Obama signed the act into law, Vice President Joe Biden famously leaned into his ear and said, “This is a big fucking deal.” It was. In Washington state, the ACA has enabled an estimated 750,000 people to purchase health insurance thanks to its sweeping provisions, which include expanding Medicaid funding and barring insurance companies from denying coverage to high-risk patients. Nick is one of those 750,000. Obamacare, as the law has come to be known, is the difference between his life with access to health care and without. That’s a big fucking deal.
As Republicans fast-track a repeal of the ACA this winter, it is vital to keep a close eye on the resulting winners and losers. Even Republicans, for all their legitimate and illegitimate criticism of the ACA, can’t deny it fundamentally affected millions of lives, and that their repeal efforts, if successful, would affect those millions once again.
Yet Republican lawmakers have been astoundingly dismissive of any attempt to talk about the fate of those Americans, those Washingtonians. Speaking to KIRO Radio’s Josh Kerns last week, State Sen. Doug Ericksen, the Ferndale Republican who co-chaired Trump’s Washington campaign, seemed to scoff at the idea that people would lose coverage if the law that provided them that coverage were to be repealed. “Obviously people like Gov. Jay Inslee and Democrats are going to try to grandstand against these changes,” he told the radio station.
Well, yes, obviously. When a law with significant state buy-in reduces Washington’s uninsured rate by nearly 60 percent, you’re damn right people are going to “grandstand” against taking the law off the books with no replacement plan on hand. Over the past week, Inslee has appeared at anti-repeal rallies with people like Joselito Lopez, who, as The Seattle Times reported, lost his job at Microsoft in 2006 after two heart attacks and couldn’t get coverage because insurance companies considered him too high-risk. Hundreds gathered in Westlake Park on Sunday at a rally held by U.S. Rep. Pramila Jayapal to protest the repeal.
This grandstanding should not—cannot—stop until the GOP clearly explains what it has planned for Nick and Joselito and all the others. In keeping to their aloof, you’ll-be-fine attitude regarding health care, the Republican Party has, either on purpose or by accident, conceded that their health-care plan should be measured by whether people lose coverage under it, as compared to the ACA. In other words, they themselves have made the near-universal coverage Obamacare achieved the metric against which we will judge their efforts. Along with foot soldiers like Ericksen stating that, in KIRO’s paraphrase, “the president-elect is not going to pull the rug out from millions of people,” Trump himself on Sunday made some extraordinary statements to that effect to The Washington Post as well—vowing “insurance for everybody” in the replacement plan for the ACA. Given the audacity of making such a statement without including any specifics, it would be foolhardy to take Trump at his word that this new plan will provide coverage to 300 million Americans while being both cheaper and more effective than Obamacare.
That said, Republican leaders are quickly amassing a large, and clear, record of statements that people will not lose their health-care coverage. They will be held to that. They must be held to that. For all the ACA’s flaws—and it is as flawed as any massive legislation that Congress refused for six years to improve would be—we have the figures: It insured 500,000 Washingtonians who did not have it before; it helped 750,000 Washingtonians in all get insurance. It insured Nick. It insured Joselito. If, in the Republicans’ bizarro incarnation as the Party of Trump, they end up passing a new version of universal health care just to spite Obama, so be it. They can take all the credit. We’ll just be happy to take the health care.
But until they do, we won’t let them forget the promises they made. That’s not grandstanding. That’s accountability. ■