President Donald Trump called them “victims of Obamacare.” He met with them this week during his visit to Milwaukee and told their stories at a rally.
The two victims, Robert Stroll of Burlington, Wisconsin, and Michael Kushman of Marinette, Wisconsin, have seen their health care premiums skyrocket. According to information released by the White House, Stroll’s health care premium rose from $780 per month to $1,500 per month. He had been enrolled in a high-risk pool, which was disbanded; his new more expensive coverage is under the Affordable Care Act.
Kushman has a similar story. He says his premium has risen to $1,422 a month—nearly a fourth of his family’s income—up from $625 a month in 2015. Kushman had been covered through his former employer before the ACA, but after 2015 his family was forced into the ACA exchange. Last year, Kushman’s insurer left the exchange, forcing them to purchase a new, far more expensive ACA plan.
But Robert Kraig, executive director of Citizen Action of Wisconsin, a nonprofit advocacy group, tells The Progressive that pointing to rising premiums as evidence there are victims of the ACA is misleading.
“In some of these cases, the person never had a guarantee that their premium would be as low as it was,” he says. “The fact that the premium went up didn’t mean it wouldn’t have gone up anyway.”
Kraig acknowledges that some are paying too much under the ACA. “There certainly are people who don’t benefit enough,” he argues. “Quite frankly, the bill wasn’t generous enough if you actually wanted to make it [health care] affordable enough for people.”
It can’t be denied that the ACA has demonstrably improved many Americans’ access to health care. Since the law took effect, an estimated 20 million people have been able to obtain health care insurance and 76 million have received preventive care. The law has also made people healthier and less likely to have medical debt.
But over the past year, premiums have risen steeply, in part because of the uncertainty over whether the law will be repealed. And while a record number of people signed up for coverage in 2017, there are still 27 million Americans without health insurance.
Republicans’ solution is to blow the whole thing up. While they say a repeal would come along with a replacement, their substitution for the ACA would make Americans’ access to health care far worse.
The Congressional Budget Office determined the Trump-supported bill that passed in the House would cost 23 million people their health insurance. The CBO also estimated that premiums for some elderly low-income people could rise by 800 percent. Even Trump, who held a Rose Garden celebration after the bill’s passage, has called the legislation “mean.”
The bill is now in the Senate, where a group of thirteen Republican senators—all men—are working on it. The Senators have met in private and are refusing to disclose any details about the shape the bill is taking, even though it will impact millions of people’s health care coverage.
One problem with the ACA is it’s a market-based solution to a human rights problem. In contrast, single-payer health care—also known as Medicare for all—would make access to health care a right, helped along by taxing the very wealthy. It’s a system used in nearly 30 countries around the world, including Canada and the United Kingdom.
Kraig says while it’s important to acknowledge the progress made under the ACA, single-payer is the only long-term solution.
“The Affordable Care Act was a critical step forward,” he says. “We needed to create a place where everyone had somewhere to go in order to get health insurance no matter what. But it did not go far enough and was not the last step in health care reform.”
Ed Weisbart, chair of the Missouri branch of the Physicians for a National Health Program, tells The Progressive that one of the problems with the ACA is that not everyone is in the system. The healthiest people opt out and choose not to have health insurance. That leaves the system flooded with the most expensive people to cover, driving up costs.
Weisbart says a single-payer, Medicare for all system would expand access to health care and dramatically improve health. Weisbart cites a study showing that among 17 peer nations, the United States had the worst life expectancy after birth, all the way up through age 65. After age 65—when Americans become eligible for Medicare—the life expectancy of seniors gradually becomes the best among the peer countries measured.
Weisbart says this shows the improvements that could be made under a Medicare for all system.
“Why limit Medicare to 65, 70, 80, 90-year-old Americans,” he asks. “Why shouldn't every American have access to what you could argue is one of the best systems in the world?”