One criticism of the Affordable Care Act (ACA), commonly known as Obamacare, was that the final bill was rewritten behind closed doors. That perceived secrecy is blamed for the ACA’s struggles today. Secrecy — then or now — jeopardizes an opportunity to craft a health care bill that truly provides affordable, accessible health care.
We live in a democracy, 240 years old and counting, that obligates us to civil debate about issues that impact the lives of 326.4 million people living in the United States. The process can be messy, time-consuming and frustrating. The end result is that voices are heard and people’s concerns are validated. Our form of government requires willingness to compromise, a challenge for all of us.
The U.S. House passed the American Health Care Act (AHCA) by a slim margin May 4 and sent it on to the Senate, whose leaders said they would make changes. Some of the bill’s cost-cutting measures, coupled with tax breaks for upper-income earners, left many Americans fearful that they or their loved ones could lose access to affordable health care if changes aren’t made. On June 13, President Donald Trump reportedly told a group of 15 Republican senators that a more generous version of the House-passed health care bill is necessary. While he earlier supported the House bill, his change of heart is a step in the right direction.
During their spring meeting in Indianapolis, the U.S. bishops reiterated their commitment to “ensuring the fundamental right of medical care” to all people. Earlier this month, in a June 1 letter to the U.S. Senate, four U.S. bishops representing their brother bishops declared that the AHCA contains “many serious flaws.” The bishops offered six moral principles they consider to be vital to health care reform.
First: If we are going to repeal and replace the ACA, we must have a bill that ensures access to adequate health care for all. Second: health care reform should not compel anyone to pay for the destruction of human life. Third: we have to consider people’s differing circumstances to ensure access that is in accord with their means. Fourth: Accessible health care must be affordable. The bishops note that “Many lower-income families simply lack the resources to meet their health care expenses.” The bishops are concerned that proposed structural changes to Medicaid would leave large numbers of people without coverage they now rely on, including those who gained access to care through the ACA’s expansion of Medicaid. Fifth: Health care should promote good health and provide incentives for preventative care. Sixth: Health care should provide for conscience protections.
The bishops shared suggestions for accomplishing these goals. Among them: removing the Medicaid “per capita cap” provisions, rejecting “health status underwriting” for those with pre-existing conditions, and retaining the cap on cost plans for older Americans at a 3 to 1 ratio.
Sen. Charles Grassley, R-Iowa, said he and his staff will continue to hear from Iowans at town meetings, through the mail, and by phone on how the ACA affects them and what they would like to see going forward. “We continue to meet with patient groups, health care providers and many others to hear their perspective,” he told The Catholic Messenger. “This dialogue is critical to the function of representative government.” (Contact him at www.grassley.senate. gov; phone: 202-224-3744.)
Sen. Joni Ernst, R-Iowa, told The Catholic Messenger that continuing the status quo isn’t an option because the ACA is “unsustainable.” As many as 72,000 Iowans could be left without an option to purchase insurance next year. “As with any reform, we must ensure that it is done thoughtfully and carefully, but also with close attention to how it will affect insurance availability in 2018 and beyond. It’s so critical that Iowans continue to make their voices heard and I encourage them to contact my office.”(Contact her at www.ernst.senate. gov; phone: 202-224-3254.)
Let’s take the senators up on their offer. From a Gospel perspective that calls each of us to serve the least among us, let us share our thoughts on what access to affordable, adequate health care should look like.
Barb Arland-Fye, Editor