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The coronavirus pandemic has disrupted my life less than that of almost anyone. Most importantly, I haven’t contracted the virus — at least not as of this writing. Beyond that, I have continued to go to the office every day, my paycheck and my husband’s have remained stable, and our sons are managing their adult lives just fine.
Since our employment has been stable, our health insurance has also been stable. This is not true for millions of Americans, because in this country, unlike our “developed” peers around the world, losing a job also means losing health insurance.
This is an Opinion
Yeah, I’m writing about universal health insurance again. Because sometimes very bad things have resulted in positive developments.
Families USA, a national health policy lobbying organization, estimated last month that 5.4 million laid-off American workers had lost their health insurance between February and May. The share of Arkansas adults under age 65 who are uninsured was estimated at 15%.
Now, 15% is dramatically better than some of our neighbors (29% in Texas, 24% in Oklahoma, 22% in Mississippi) for a reason that should be obvious: Those states rejected the Medicaid expansion made possible by the Affordable Care Act — Obamacare — while Arkansas accepted the money and used it to buy private health insurance for households earning barely above the poverty level.
Our state attorney general, Leslie Rutledge, is one of the Republican AGs from around the country who are seeking to have the entire ACA declared unconstitutional. I don’t know if the U.S. Supreme Court will see it their way when an opinion is produced, probably next year, but the timing could not be worse.
Perhaps when the challenge was originally filed in early 2018, there was some hope that the Republicans who controlled the White House and both houses of Congress would deliver on eight years of repeal-and-replace promises in time to salvage the parts of the ACA that enjoy broad appeal. Those include guaranteed coverage for pre-existing conditions, family coverage for adult children up to age 26 and tax subsidies that make individual plans more affordable for middle-class households.
There was presumably no thought that the effort to kill the ACA would come during a pandemic that reduced the GDP by nearly a third in one fiscal quarter. And, obviously, the ACA has not been repealed or replaced. Even President Trump recently suggested (by tweet, of course) that the only path to replacing the ACA required the Supreme Court to first “terminate” it — as if he and Congress were powerless to deliver on his 2016 campaign promise of cheaper, better insurance for everyone.
Comprehensive health insurance legislation is not going to happen this year. Just keeping the bottom from falling out seems to be more than Congress can muster. But eventually this crisis phase will end, and we will have the opportunity to address the systemic weaknesses that have been revealed. One of them is what I consider to be the worst part of Obamacare: the continuing dependence on employer-sponsored health insurance.
We need universal insurance. My preference remains a government-sponsored, mandatory, high-deductible system known as universal catastrophic coverage, but I’m open to all ideas.
I’m hopeful that some lasting changes for the better will come out of COVID-19 because that’s a common thread in human history.
Joe Scott, proprietor of a YouTube series called “Answers With Joe,” recently did a strangely encouraging episode called “How Hard Times Create a Better World.” Among his examples:
► The Black Plague that killed millions in Europe in the Middle Ages also killed the feudal system and created the first middle class;
► The airline catastrophe that killed 583 people on the Spanish island of Tenerife in 1977 spurred worldwide standardization of flight protocols, dramatically reducing the number of commercial aircraft crashes and the number of associated deaths;
► The Great Depression spawned, among other things, Social Security, which remains wildly popular because it has brought a measure of financial stability to old age. (And it did so without killing the private retirement planning industry — something to keep in mind when we start talking about alternatives to our health insurance patchwork.)
Another example from Joe Scott that was entirely new to me: Looting of electronics stores during the blackout of New York City in July 1977 is credited with jump-starting the hip-hop music phenomenon. Go figure.