Republicans promise something terrific
Despite the constant negative rhetoric about Obamacare from some quarters, there are many facts that frame its success.
Every Republican presidential candidate thinks the Affordable Care Act (ACA), championed by President Obama and delivered by our own Sen. Harry Reid, has been a disaster. They are rewarded with resounding cheers of approval the instant they proclaim they will immediately abolish Obamacare if elected president.
And yet, the evidence that the ACA is dramatically reducing the numbers of uninsured Americans continues to grow, especially in Nevada.
The latest report from the Georgetown University Center for Children and Families showed Nevada’s rate of uninsured children dropped more than any other state 2013 to 2014, from 14.9 percent to 9.6 percent. As usual for Nevada, the gap between our state and better performing states is huge, so even though the 5.3 percent decrease is significant, Nevada still ranks among the top five states for uninsured children.
Nevada’s improvement can be linked to Gov. Brian Sandoval’s decision to accept the federal government’s offer to expand Medicaid under the ACA, a decision ratified by the Legislature. Sandoval was the first Republican governor to accept the federal dollars to pay for 100 percent of the expansion, although the federal reimbursement gradually decreases to 90 percent of the cost by 2020. He rightly reasoned the insurance expansion would create jobs, help hospitals deal with the high numbers of uninsured patients, and eventually decrease insurance costs for everyone.
It was a good gamble since the number of uninsured Nevadans has been cut in half.
Nationally, the decrease in the number of uninsured has been larger than at any time in the last five decades, matched only by the mid-1960s when Medicaid and Medicare were created.
States such as Texas with Republican governors who remain adamant in their hatred of Obamacare and refuse to expand Medicaid continue to lead the nation in the number of uninsured citizens, despite paying taxes to the federal government that are then used to insure Nevadans and others in Medicaid expansion states.
Although there are many aspects of the ACA that need more attention, such as the “cadillac tax” for high-end health plans or allowing people in low-population states to access more competitive insurance plans across state lines, it is increasingly apparent that Obamacare has been a huge success at its most basic level of increasing access to health care.
But Republican presidential candidates continue to insist the ACA is one of the country’s biggest failures, and promise to “repeal and replace” Obamacare, although they’re vague on what the replacement will be.
Some of their comments are so over the top, it makes you wonder why anyone would take them seriously. The current front-runner, Ben Carson, who has never held elected office insists, “You know Obamacare is really I think the worst thing that has happened in this nation since slavery.” Maybe he should speak with the parents of those Nevada children who now have coverage to see if they would agree.
Jeb Bush offers the more standard Republican rhetoric, saying “This fatally flawed law imposes job-killing mandates, causes spending in Washington to skyrocket by $1.7 trillion, raises taxes by $1 trillion and drives up health care costs.” This, despite many reports that health care spending has slowed under Obamacare.
The best line, of course, belongs to Donald Trump, who in a previous life enthusiastically endorsed single-payer health care as the best approach. Now, he just says, “It’s gotta go. Repeal and replace with something terrific.”
Finally, something The Donald and I agree on. Canada and Great Britain have single-payer plans and spend far less for health care but manage to have universal coverage with much better outcomes. Replacing Obamacare with single-payer would indeed be “something terrific.”