“The motto of the healthcare professions is to first do no harm,” says Deb Friedland, who has been a registered nurse for 23 years at St. John’s Episcopal Hospital in Queens, New York. “That’s why I can’t believe that the first priority of the new Congress is to repeal the Affordable Care Act, because it would be devastating to the hard working people in our community, our local economy and our hospital.”
If Congress pushes forward with destroying the ACA, over 2.7 million New Yorkers would lose their health insurance, the state budget would be slashed by $3.7 billion, and 27 hospitals throughout the state would be in danger of closing.
With all the struggles facing working Americans — stagnant wages, increasing student and consumer debt, lack of job security — it is staggering that Congress would choose as its first move the repeal the Affordable Care Act. The ACA has expanded health insurance to more than 22 million people overall, 70 percent of whom can purchase plans through the online insurance markets for less than $75 a month because of subsidies. Large companies are required to provide healthcare to employees, and Medicaid has expanded to working families near the poverty line. Nationally, the number of uninsured has fallen from 16 percent to 8.9 percent, the lowest in history. In our state we have done even better, and now 95 percent of New Yorkers are covered.
The act also created important patient protections, such as the ban on discriminating against patients with pre-existing conditions, allowing young people to stay on their parents’ plans until age 26, and preventing insurance companies from charging women more than men for the same coverage.
But the Affordable Care Act’s goals, which were just beginning to be realized, were even loftier than providing affordable healthcare to all Americans. The ACA sought to bring about a sea change in how healthcare is delivered in the U.S., so that patients are given the medical advice, tools and support to live longer, healthier lives.
The U.S. spends more on healthcare per person than any other country, but we have worse health and mortality rates, and our wasteful healthcare spending has been threatening other vital programs such as Medicare and Social Security. The ACA put in place a system that began moving us away from a “fee-for-service” model — which encouraged unnecessary procedures and inefficiencies — to a “value-based” model which spurs healthcare providers to promote the comprehensive well-being, health and satisfaction of their patients.
In other words, the Affordable Care Act rewards doctors for keeping their patients healthy and out of the hospital — through disease prevention, pain management and guidance on healthy lifestyles — instead of just admitting patients to the hospital after they are already severely ill.
“Before the Affordable Care Act, our emergency room was always gridlocked with long waits, because that’s how people without insurance would get their healthcare, and they would come in really sick with diabetes, liver failure, asthma, cancer, you name it,” says Deb. “But since the ACA was passed, our emergency room isn’t as overloaded because more people have insurance, and they’re able to get preventative care and advice on healthy living from their doctors.”
The right-wing politicians who have been railing against the ACA will find themselves on the wrong side of history. Across party lines, working Americans support lowering the amount individuals pay for healthcare, and guaranteeing a certain level of health coverage for seniors and those with lower incomes.
What’s more, the torpedoing of the Affordable Care Act is not smart strategically for Congressional Republicans, because it is an attack on the very working people that Trump purported to want to help during his campaign. Millions of Republican voters in states all around the country stand to lose their health insurance due to the repeal. 56 percent of those who would lose coverage are white, and 80 percent have less than a college degree.
Yes, there are ways the ACA needs to be improved, such as reducing the cost of premiums and prescriptions, but this should be done through a process of adjusting, rather than repealing, the law. That’s why leading physician groups, including the American Medical Association, have called on Congress to create a replacement before repealing the Affordable Care Act. Our union has demanded that any replacement must meet the standards of maintaining coverage for the 22 million who have gained insurance, preserving patient protections and continuing Medicaid funding.
“I went into nursing because it’s a trusted and respected profession and I believed I could make the greatest positive impact on the patients in my community,” says Deb. “So please trust me now when I say as a lifelong nurse, a mother and a grandmother: call your Congress members and tell them this is a matter of life and death. Having affordable health insurance is not a Democratic issue or a Republican issue, it’s a human issue.”
George Gresham is president of 1199SEIU United Healthcare Workers East, the largest healthcare union in the nation.