As a cardiologist, I have seen countless examples of patients in seemingly good health who suddenly are struck with a life-threatening illness. These unfortunate people may find themselves with longstanding requirements for life-sustaining medication and medical followup.
Without health insurance, how can they survive without facing huge medical bills, which potentially might bankrupt themselves or their families? President Obama and Congress attempted to address this existential need by passing the Affordable Care Act in 2010.
The Republican fury to obliterate the ACA is ill-advised. The motivation appears to be political: the act was passed years ago by Democrats, without Republican support, despite the fact that the plan was based on a once created for Massachusetts by Republican Gov. Mitt Romney.
The people of the United States have benefited greatly from the ACA’s existence. Before the law was enacted, nearly 50 million Americans had no health insurance and no access to Medicaid or Medicare. The intent of the law was to broaden insurance coverage and reduce health-care costs. Congress sought to improve the quality of the health insurance sold and improve its affordability.
Since the law was passed, more than 20 million people have been able to acquire insurance coverage. In order to spread the risk, insurance (whether provided at work or purchased individually) has been mandatory, with participation encouraged through use of a tax penalty. Many have taken advantage of state exchanges to buy grades of insurance with varying levels of coverage at different costs. Those with pre-existing conditions have gained insurance coverage at a cost similar to anyone else. Young people under age 26 have been covered under their family’s plan. Medical cost increases have slowed. Increases in insurance premiums have been buffered by partial federal subsidies for these higher costs. Growing families have been protected from unplanned economic disaster as a result of the threat of lack of medical insurance coverage.
Consider the financial crisis for an individual or family created by an unexpected major illness if no health insurance were in place. Bankruptcy would be the likely result. This calamity could happen to any of us without coverage. Think about it.
The Republican exuberance to immediately repeal the ACA threatens to leave out millions of Americans in need. If a better plan is proposed, Congress should propose it. It should not disenfranchise millions of Americans now with the intention of someday coming up with some better plan.
If the ACA is repealed without an acceptable replacement plan in place, vulnerable people will be put at risk and millions will be without protection while a replacement plan is being debated. I doubt that sufficient agreement exists among Republicans to find common ground quickly. In the meantime, people may die without coverage.
I object to the reckless behavior of the Republicans in Congress. I urge our senators and representatives to vote against the repeal of the ACA without a satisfactory replacement plan in place.
Dr. Peter K. Shaw lives in Falmouth.