Can you put a value on a human life? You probably don’t know the answer to that, and neither do I. Yet, our policies and our politics continue to reflect an unintentional answer to that question: Yes, we can. The latest effort of conservatives in Washington has been to dismantle former President Barack Obama’s health-care law, the Affordable Care Act — legislation that aimed to promote good health for all Americans, not only some. Conservatives’ long-awaited replacement to one of Obama’s trademark pieces of legislation has, finally, come to fruition. Kind of.
Two weeks ago, House Republicans announced their proposed plans to replace the ACA with the American Health Care Act. Yet, unsurprisingly, the plan was met with disdain from Democrats as well as hesitation from moderate Republicans. Keeping up with their historical opposition to Obamacare and now, with the new president’s concerted effort to take two steps backward from the progress of the past eight years, the GOP is taking U.S. health care in a new direction. A direction where subjective politics is outweighing objective health equity.
Under the AHCA, the budget office predicts a rise in premiums in the coming years and estimates that 52 million Americans will become uninsured by 2026. While saving $337 million, and subsequently going along with conservative aims to limit big government, the new plan, if passed, would be a blow to improving health equity across the country. In contrast, its predecessor reduced the number of uninsured Americans and was the beginning effort to close the health gap.
Further, the proposed plan, approved by the House Budget Committee, takes a toll on poorer Americans, as the expansion of Medicaid in states is predicted to decrease. At the same time, older Americans will be at risk. New provisions of the replacement would allow insurers to “charge older adults five times more than the young.” Without a doubt, the proposed GOP replacement works against the ideal of making health a right, not a privilege, an ideal much of Washington has yet to embrace.
Republicans got really good at preaching “repeal” throughout the Obama administration, but their efforts to produce a good replacement are thoroughly lacking. Further, the new AHCA breaks a promise Mr. Trump made just two months ago, “We’re going to have insurance for everybody.” Unfortunately, that doesn’t seem like the case.
The politics surrounding the health-care debate seem to be overshadowing what’s truly at risk: the well-being of Americans. House Republicans, unsurprisingly, are jumping at the chance to get rid of the dreaded ACA, but their efforts to re-align political power has the potential to take a devastating toll on Americans across the country. It begs the question: Is the new law being driven by pure politics, or by the millions of Americans who depend on government aid for a healthy life in mind? The entrenched political polarization when it comes to health care has effects that go beyond the walls of Congress; it is affecting real Americans who need real insurance.
This isn’t to say that all Republicans are backing the new replacement. In fact, four Republican governors recently spoke out against the proposal, highlighting the flaws of the AHCA when it comes to taking care of lower-income Americans. But, even more telling is the opposition by the American Medical Association. Last week, members of the group sent letters to the House about their concerns when it came to providing affordable coverage to low- and middle-income Americans. Maybe, instead of leaving it up to officials in Washington and the divisive politics of it all, health policy should take into account the medical professionals and experts whose daily lives revolve around the health of Americans.
There is no question that health care contributes to a healthy population and, even more, a productive population. The ACA was a measure that, as its name states, accounted for those who could not afford health insurance, and thus could not afford to take care of themselves and their families when sickness or injury arose. However, while the ACA targeted those who needed coverage the most, the new health-care act is backtracking. Instead, the AHCA has the potential to make insurance unaffordable for millions.
Unlike Obamacare, the replacement no longer requires every American to become insured. Instead, it approaches health care with an age-rating structure. This ultimately takes a toll on the poor, sick and elderly, as The Atlantic explains. But, younger and therefore typically healthier Americans will be paying lower premiums while the elderly will be paying more. That doesn’t sound too bad for a post-grad who will no longer be covered under their parents’ insurance plan at 26. However, when it boils down, the irrefutable problem in the AHCA remains: Those who need health care the most are those who will be facing the most obstacles to get it.
While the ACA was a step forward in altering the way we think about health in America, it still did not fully embrace the concept of health as a basic right. Now, the proposed replacement has thrown this idea out the window. By making health care more expensive and thus available to only those with the economic resources to afford it, we are valuing the health and well-being of some Americans over others. What’s more, we’re not supporting the well-being of those who need it the most. Low-income and impoverished areas are more susceptible to lower life-expectancy than the rich, and without affordable measures to prevent disease and injury, the disparity between health outcomes will continue to increase. By letting economic circumstances be the dividing barrier between those who have health services and those who do not, we are placing more value on some lives than others.
The way we talk about health care right now is ridden with politics. Yes, politics play a key role in developing effective policy and law. But issues of basic rights, like the opportunity for a healthy life, go beyond the liberal-conservative debate. More importantly, these rights are something that everyone, regardless of party and age, must fight to ensure and preserve. The idea of taking care of our own seems lost these days and the AHCA seems like yet another step away from a more empathetic America.
Anu Roy-Chaudhury can be reached at anuroy@umich.edu.