O is for Obamacare

iheartobamacare_400pxFirst off, let me just say that I believe single payer is the way to go. No system is perfect, but single payer delivers quality healthcare more equitably, efficiently, and cost-effectively.

That said, I’m a huge fan of the Affordable Care Act, aka Obamacare. Yes, its origins lie in conservative think tanks like the Heritage Foundation and the American Enterprise Institute, which promote market-based policies that privilege the profit motive. Obamacare does not go nearly far enough for many, including me.

Yet it’s what could get through a political system that is sclerotic, controlled by monied interests, and held hostage by a Republican Party practically unhinged in its hatred of President Obama.

It’s a profound success that more than 16 million Americans now have health insurance they couldn’t before afford or couldn’t get due to preexisting conditions. Obamacare is also slowing skyrocketing healthcare costs.

My family has been among Obamacare’s many beneficiaries:

For one thing, our kids have been covered under my husband’s employer-provided insurance until they turn 26. Since Emma aged out last year, she’s been fortunate to get healthcare she could not have otherwise afforded. Pieced-together, low-wage employment is common for young people now: Emma survives as an artist on part-time Russian translation work while also working in a restaurant.  Initially, Emma benefited from Medicaid expansion (again, she’s lucky to live in a state that opted into this provision of the law). Now that she’s a bit more stable economically, subsidies help her afford excellent health care through our state’s health exchange. When our younger daughter, Ally, moves back this summer from Spain (where she’s enjoyed the benefits of national health care) she, too, will be able to find affordable health insurance.

Of course, since Ally’s only 24, she could also still be covered under my husband’s plan. Except that he’s retiring in May! This, too, is something he never could have done before Obamacare. We’ve both had cancer, which involves ongoing monitoring. I am self-employed, and there is no way we could have gotten individual insurance because of our pre-existing conditions—a heinous denial of coverage that Obamacare outlaws.  Now my husband can pursue other interests free from the burden of remaining tethered to a job simply because we need health insurance we otherwise couldn’t get. And somebody else who needs and wants a job can have the position my husband will soon vacate.

Sure, we’ll pay a lot for coverage on our own. We’re too well off to qualify for subsidies, which is as it should be–they are designed to help those less fortunate. Of course, we’ll still benefit from annual out-of-pocket caps, free preventive services, and the knowledge that we and tens of millions of other Americans will no longer have to worry about the Russian roulette that used to be national policy.

Don’t get me wrong—I know that Obamacare is far from a panacea, and that for those who are healthy and whose incomes are a little but not a lot above the subsidized level, health insurance is far from affordable. For some it’s become more expensive. And because our system has engendered such a complicated law, tax season has become even more migraine-inducing than usual.

Yet we should be careful not to blame Obamacare for what had been happening for years anyway—premiums skyrocketing, people getting dropped, families going bankrupt due to lifetime caps, employers reducing hours to avoid providing benefits, or simply no longer offering health insurance at all.

It is a reform in process, but its benefits far outweigh whatever drawbacks exist.

What saddens and outrages me the most, though, is how much energy has been put into destroying rather than improving Obamacare. And I’m not even talking about the lies (remember death panels?) designed to thwart it from the get-go. The Supreme Court allowed states to opt out of Medicaid expansion, leaving millions of poor Americans who live in 23 (mostly Republican-controlled) states uncovered yet unable to afford healthcare on the exchanges.

Now even the federally managed exchanges (set up because so many of these same states refused to take responsibility for their own residents, and passed the buck to the Feds they deplore) are at risk as the Supreme Court considers King v. Burwell. If the Supreme Court rules in favor of the plaintiffs in a case that is based on what most see as the political exploitation of a semantic glitch, it will likely prove Obamacare’s unraveling. Which is exactly what its scorched-earth opponents want.

What do I want? It’s simple, really. I want a law that has helped tens of millions of Americans already, and which promises to benefit many more in the future. I’m grateful to President Obama for achieving what no other president had been able to accomplish.

Please—hands off our Obamacare!

Health Care for the Holidays

Covered California home page

A version of this piece recently aired on KQED’s Perspectives.

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With the holidays here, I know just what I’m going to ask my daughter for this year. Emma’s almost 26, and like a lot of young adults, she’s piecing together a couple of part-time jobs while figuring out what comes next. I don’t want her to spend her hard-earned cash on stuff I don’t need. Instead, I’m asking Emma to make sure she signs up for something she needs: health insurance under the Affordable Care Act.

It’s true that the rollout has been riddled with problems, but the Affordable Care Act’s tremendous benefits remain. Besides, Californians are lucky to have Covered California, the state’s fully functional and easy-to-navigate healthcare exchange. Those who enroll by December 23 will be covered when the law goes into effect January 1. What better way to start the New Year?

Our family has already benefited greatly from the Affordable Care Act–it’s allowed us to keep our daughters on our plan until they turn 26. Soon, though, Emma will need her own health insurance. Before, she never could have afforded it. It’s hard to find jobs these days that offer coverage. Emma, like millions of Americans, might have been forced to rely on costly ER visits or the “Cross my fingers and hope I don’t need it!” plan. Now, under the Affordable Care Act, she and the many Californians like her who’ve risked disaster due to unattainable insurance will be eligible for expanded Medicaid, federal subsidies, or tax credits.

As parents, we make sure our kids are safe: teaching them to buckle up, wear bike helmets, and drive defensively. Grown-up children may think of themselves as Young Invincibles who don’t need insurance, but accidents and serious illness happen, putting health and family finances at risk. Here’s our chance to further guide our kids into responsible and secure adulthood, continuing to protect them by making sure they’re covered.

That’s why I’m asking Emma for the best present of all: good and affordable healthcare for her, peace of mind for me.

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Covered California: www.coveredca.com or 800-300-1506

Other states: check your local resources or www.healthcare.gov or 800-318-2596

Open enrollment period ends March 31, 2014