Failure of the AHCA: Is there a reason to rejoice?

Over the last 24 hours many have expressed jubilation over the Republicans’ failure to pass the American Health Care Act. As a physician and health advocate, I see little reason to rejoice because the dissent marshaling the failure was primarily from those who wished to gut the bill even further. This means the next iteration — and I am sure there will be a next — is likely to be even more restrictive. Most people don’t appreciate the value of the Affordable Care Act (ACA) because we don’t hear about its full impact in the media. Instead we only hear about skyrocketing premiums and Medicaid ‘hand outs’ for the poor. Did you know Medicaid pays for nursing home stays, care for the disabled and working families with children who can’t afford to buy from private insurers like Humana and Aetna? Did you know Medicaid also covers health care costs for many our nation’s children? We must protect these assurances of health care. However, I see a few major challenges in doing so:

  1. The messages controlling the narrative, i.e. “It’s a disaster”, “bad health care”, etc. are severely imbalanced. In addition to not only being about the poor, the ACA is not the culprit for delivery of so-called ‘bad health care’. This characterization is about the high cost of premiums for an unknown number of people. I’ve had many patients insured for the first time through the ACA and I take issue with anyone believing we delivered bad care. Citizens who’ve benefitted from the ACA must speak out to help balance these messages.

2. Insurers are responsible for unfairly raising premiums to stabilize profits and no one, including the public, is calling them out on it. Insurance companies are a powerful lobby so why would Congress regulate them more to protect Americans from unfair premium hikes?

3. Numerous people have told me, ‘I don’t want government mandating what I can and can’t do.’ This is interesting to me. Do you pay taxes? That’s only one example. What about home owner’s or car insurance? You can’t buy a house without mandated insurance. What happens if you’re caught driving a car without insurance?

Our problems are often rooted in our inability to compromise and look out for each other. This is no different. Ultimately we have to hold Congress accountable for representing us. If the narrative you’re hearing about the ACA doesn’t represent you- that’s a problem. If the narrative you’re hearing about the ACA ONLY represents you- that’s a problem.

Let’s not rejoice until we have found a better solution.

Photo by Lisa K. Fitzpatrick, MD