POSITION PAPER ON THE AFFORDABLE CARE ACT

OUR GUIDING PRINCIPLES

  • Hudson Valley Strong believes health care is a right, not a luxury.
  • Hudson Valley Strong believes that healthy, productive communities benefit us all; healthcare is not just a benefit for individuals.
  • Hudson Valley Strong applauds the success of the Affordable Care Act (ACA), which has brought the United States closer to the goal of universal health care coverage than ever before.
  • Hudson Valley Strong will resist all efforts to repeal, weaken, undermine, or reduce the effectiveness of the ACA.
  • Hudson Valley Strong supports and urges passage of Democratic proposals that build upon the ACA’s success.

BACKGROUND

The ACA has brought the United States closer to the goal of universal health care coverage than ever before.

 The ACA marked the largest expansion of health care coverage since Medicare and Medicaid in 1965. As a result, the United States has made enormous strides toward the goal of universal health care coverage for all Americans.

Many of the new regulations enacted under the ACA protect even people who have employer or other non-ACA marketplace insurance plans.

Here are a few of the ACA’s signal accomplishments:

  • Over 20 million Americans gained health care insurance under the ACA.
  • Insurance companies may no longer discriminate against people with pre-existing conditions.
  • Young people are able to stay on their parents’ plans until they are 26.
  • The ACA ended lifetime limits on coverage for everyone. Previously many policies typically had lifetime limits of 1 to 5 million dollars – an amount that could be quickly exhausted!
  • The ACA requires insurers to offer everyone a minimum package of benefits, with no co-pay for preventive services.
  • The ACA limits how much more insurers can charge older people than younger people. (This also protects companies who employ older workers.)
  • Under the ACA, no insurance company can charge women higher rates because of their gender.

For more, go to Appendix A.

Congressional Republicans are intent on undermining the ACA’s success.

Congressional Republicans, rather than recognizing this milestone and moving forward to reach the ACA’s ultimate goal, are intent on turning back the clock. Their proposals to “repeal and replace” the ACA would strip health care coverage from tens of millions of individuals and increase health care costs for millions more. Notably, they aren’t reaching across the aisle to consider the 6 year’s worth of carefully researched Democratic proposals offered to build on the success of the ACA. The re-branding of their efforts under the guise of “repair” does not change their intent, which is to weaken, undermine, and—if they can get away with it despite the ongoing firestorm of public disapproval—dismantle the ACA.

The takeaway?

We should greet with suspicion all Republican proposals, as they are bound to revive ideas that didn’t make it into the law precisely because they worked against, not in furtherance of, the ACA’s goals.

Favorite Republican proposals that would revive the bad old days pre-ACA include:

Medicaid block grants. “Turning Medicaid into a block grant to states would lead to steady reductions in funding for the poor, elderly and disabled in most states. During recessions or health emergencies, states would not have the federal funding to help more needy people without reducing benefits for others.”

[From Scholars Strategy Network (SSN), What Trump Means for the Affordable Care Act]

High risk pools. As Professor Skocpol advised Hudson Valley Strong by e-mail, “State based risk pools would be a terrible deal for most Americans, tens of millions, with preexisting or serious health conditions. That has long been the GOP idea about what to do when insurance companies are allowed to avoid such people or charge them more—a situation that repeal [of the ACA] would bring back. However, risk pools are never adequately funded to meet demand and current GOP repeal ideas would not provide anywhere near enough funding. The whole idea of health insurance is that everyone pays and gets affordable coverage when sick. Shunting the sick off into separate pools does not work.” [Italics added.]

Trumpcare. And now we have the so-called “American Health Care Act,” where every bad Republican idea has found a home. We’ve created a separate Appendix B1 with a selection of articles that discuss aspects of the bill.

For more, go to Appendices B1 and B2.

Not so fast, John Faso: Lining up Congressman Faso’s statements with the facts.

While Representative John Faso (NY-19) has so far ducked town meetings, he has made public statements on the ACA. Our take-away after examining his statements is, when Faso speaks, be wary. Even if something sounds good at first blush, it ain’t necessarily so.

Pre-existing conditions. The ACA provides not only that a person can’t be denied insurance coverage altogether because of a pre-existing condition, but also that insurance coverage must include, from day one, coverage for “essential health benefits” related to the pre-existing condition.

While Faso has promised to make sure the ACA provision survives, he touts as his model the pre-ACA New York law, which offers no such guarantees.

For more, go to Appendix C1.

Faso’s Poughkeepsie Journal Op-Ed Piece. Professor Skocpol wrote to us, on review of Faso’s Op-Ed Piece, that it “hews pretty closely to standard GOP ideas.”

The Op-Ed repeats again, in writing, the same talking points that we’ve heard him say in person when we protested outside his home, at business organization events, on the radio, and on television. Other Republicans parrot these same key points, so we suspect that these are the ‘official’ talking points on the ACA. The fact that he can’t, or won’t, go into more details about Republican plans for the ACA might be one of the reasons he isn’t holding public town halls.

Professor Skocpol’s takeaway is this:

“What your Congressman is not acknowledging is that all GOP repeal plans are about slashing taxes on business and the wealthy that pay for tens of millions of more Americans to get affordable coverage. Limits in the existing system have to do with NOT ENOUGH MONEY to fully lower premiums and co-pays for middle class Americans. Americans tell pollsters they want more help, not less. But the GOP repeal ideas would simply give the wealthy huge tax breaks and make premiums less affordable, raise co-pays, and leave tens of millions without good or any coverage.”

For more, go to Appendix C2.

HOW TO BUILD ON THE ACA SUCCESS STORY

If Republicans, including John Faso, are sincere in their wish to build on the ACA’s success, we call upon them to join in supporting proposals that Democrats have long advocated. A sample is below:

  • offer a national public-option insurance plan to broaden choices
  • expand Medicare to allow those 55 or older to opt in
  • provide new incentives to encourage all states to expand Medicaid
  • expand investments in community health centers to broaden access to primary care so that people can stay healthy and employed
  • strengthen the authority to block unreasonable health insurance rates
  • vigorously enforce anti-trust laws to scrutinize mergers and ensure they do not harm consumers

Democratic proposals that complement the ACA goal of affordable, quality health care coverage for all Americans include the below:

  • allow Medicare to negotiate drug and biologic prices
  • crack down on rising prescription drug costs and holding pharmaceutical companies accountable
  • invest in making a cure for Alzheimer’s possible by 2025
  • put treatment of mental health on a par with that of physical health and enforce mental health parity to the full extent of the law so that people can stay healthy and employed
  • combat the scourge of drug and alcohol addiction affecting so many families, and ensure that anyone suffering from addiction has access to the comprehensive, ongoing treatment necessary to stay in recovery and rejoin society as productive individuals

For more, go to Appendix D.

WHAT CAN WE DO, AS INDIVIDUALS? 

  • Tell your personal stories about pre-ACA experiences and how the ACA helped you. Encourage others to tell their stories, too.
  • Follow the lead of Democrats in Congress we respect. If they are standing pat, we should too. Let’s not given in to panic and cave into the Republican agenda.
  • For those in districts with Republican representatives, never forget that Paul Ryan and HHS Secretary Price are the deciders. Individual Republican Congress people will basically be left with voting up or down on bills to gut the ACA. Our efforts, therefore, should be to call upon our representatives to vote no, and to hold them accountable if they do not.

ADDITIONAL INFORMATION AND RESOURCES

The Appendices to this document contain additional information and links to sources for statements made in the text.

Please note: This position paper was posted February 27, 2017. There are many good sources for keeping current, including articles on the ACA at the Center for American Progress, the HealthAffairs blog series “Following the ACA,” the Scholars Strategy NetworkSarah Kliff’s posts on the ACA in Vox, and Indivisible’s Stop Trumpcare” resources. Also, right here in CDNY-19, make sure to check out Carol Peckham’s blog “Keeping an Eye on Affordable Care.”

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With grateful thanks to Professor Theda Skocpol for offering her insights, including providing us with comments on the Faso Op-Ed piece (Appendix C2). While the opinions expressed here are our own, Professor Skocpol’s insights and the materials available at the SSN were invaluable in informing our work.

Professor Skocpol is the Director of the SSN and Victor S. Thomas Professor of Government and Sociology, Harvard University. Skocpol’s research focuses, among other things, on health reform, social policy, and civic engagement amidst the shifting inequalities in American democracy. Current projects include tracking the implementation of health reform in the U.S. states and analyzing the dynamics of local Tea Party groups. More about Theda Skocpol and the SSN may be found here.

 Hudson Valley Strong is an Indivisible-aligned group in New York State’s 19th Congressional District, which is a swing district. We work to protect our people, our values and our environment through individual action and in coalition. We defend the progress that has been made and stand against Trump, Trumpism and the reactionary Republican agenda.

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