I don’t usually get political on the blog, but today the Affordable Care Act (also known as Obamacare) is all over the news. The new healthcare insurance exchanges are going live in states across the nation, and at the same time, the Republican party has shut down our government over it.
This post isn’t going to be a statement of facts about why the Affordable Care Act is a good thing. You can read that elsewhere. I have a personal story to tell, one I don’t share all that often, about growing up in America as a member of the uninsured working-class poor. I’m pretty successful today, thanks in large part to contributions from America in the form of free public education and subsidized student loans. I feel like I have a responsibility to tell my tale.
My sister and I were children of a single mom. To understand our situation, you have to ignore the stereotype you have in your head of a welfare family, because in fact my mom always worked. That was actually part of the problem. If you’re on welfare, you qualify for Medicaid, which provides both medical and dental benefits. If you’re working in a low-wage job (as were most employed women in the 70’s), you don’t. My mom was a journalist and still didn’t make enough to afford insurance, and the small businesses where she worked, mostly locally owned newspapers with staffs of 4-5 people, couldn’t afford to provide it either.
So, we went without. Usually that was okay but sometimes it was terrible. I remember times when we had to choose between taking my sister to the hospital for appendicitis and having money for groceries. I remember a doctor telling us we couldn’t have any more care until we paid a bill that was probably more than my mother made in a month. I remember struggling through pneumonia trying to kick it on my own because we couldn’t go to the doctor.
Ironic, then, isn’t it, that I eventually ended up working in the insurance industry. I’ve watched the way we sell health insurance to the private market and always thought it was crazy. If your employer doesn’t provide it, you are pretty much out of luck unless you are very wealthy.
So why do I support the Affordable Care Act? For starters, because I’ve actually read the law. The Entire Thing. Yes, like all bills passed by our lovely Congress, it’s got some fat in it, and even I was surprised when the individual mandate was held to be constitutional. From the insurance company perspective, the individual mandate is really important, because without it, the numbers simply don’t work once you remove the pre-existing condition clauses. (And let’s face it, they were one of the worst parts of the insurance market previously. You could get sick, lose your job, and suddenly be without health insurance at a time when you needed it most).
As a parent of young adults, the ACA gives me the ability to keep my kids on my insurance until they’re 26 rather than sending them out into a broken open market where individual coverage costs thousands of dollars a month and there is essentially no competition.
As a small business owner, I can use the SHOP marketplace to offer real coverage to my employees at a cost I can afford.
Preventative care like mammograms, flu shots, and other things that improve health outcomes and save lots of cost are now fully covered.
These are the things that benefit me the most – mostly tweaks to the existing marketplace that don’t cost any tax dollars. There are lots of other things in this bill that will help others.
Is it perfect? Of course not. No law ever is, especially when it comes from something as complicated and political as our Congress. But is it worth saving? I think yes, and frankly I’m saddened by the current tactics that would harm business and our economy by shutting the government down just to get political leverage.