Exactly 11 years ago, then-Vice President Joe Biden watched President Barack Obama sign the Affordable Care Act into law. It was the only health care expansion in America over the past decade — until now.
The ACA originally offered subsidies to low-income families and full price insurance for many middle-class and high-income families. Through Medicaid expansion, poor and working-class families could access free or low-cost care. This meant that the richest and poorest could afford care, but the people in the middle were often left out.
That changed when President Biden signed the American Rescue Plan this month. Its goal is to help everyone and bring health care within reach to all. It doesn’t matter how much you make, you will pay no more than 8.5% of your income on insurance premiums in the individual market. This reframes the ACA as a much more universal program, like Social Security or Medicare. It also includes incentives for the 12 states that have not expanded Medicaid to cover their poorest residents, if they choose to take it.
What Biden promised me last summer
This is personal to me because the Affordable Care Act saved my life. As a small business owner, my insurance is through the ACA. When I was diagnosed with stage 4 cancer four years ago, my policy picked up the half-million dollar price tag it took to keep me alive, get me through six months of chemotherapy and a month of radiation treatments. Today I’m in remission.
I could afford a full price health insurance policy through the ACA. I lived. Some Americans couldn’t, and they are no longer here.
As the executive director of Get America Covered, a nonprofit formed by Obama-era health care veterans, I talk about the importance of getting everyone covered with affordable health insurance. But too often, I was reminded that policies were out of reach financially for many middle-class families.
The American Rescue Plan is just the beginning of how President Biden proposes to reshape our health care. He also pledges to tame the pharmaceutical companies and work toward lower drug prices for everyone, and to go even further on behalf of lowering health care costs for Americans.
Last summer, then-candidate Biden promised to me at the Democratic National Convention that he would work toward a public option. Biden said that he would provide a Medicare-like option as a public option, and that he would protect us like he protects his own family. More competition from a public health insurance option could lower health care costs for everyone.
In fact, the original design of the Affordable Care Act included a public option, but it was killed by opposition from Sen. Joe Lieberman, a former Democrat turned independent.
Since the Affordable Care Act took full effect in 2014, Democrats have tried many times to shore up weaknesses in the original law. But congressional Republicans have blocked reform at every turn, choosing to attack the ACA rather than improving it.
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The day after my first chemotherapy appointment in May 2017, House Republicans voted to dismantle the ACA, which was keeping me alive. I became an accidental activist, fighting for my life. This inspired me to start my own nonprofit group, Health Care Voices, to organize people with serious medical conditions and give us a voice in the health care fights directly affecting our lives.
This should not have to be a partisan issue. A majority of Americans for the past couple decades have supported the idea that government should ensure everyone has health care. And today, a majority of Americans strongly support Biden’s health care agenda.
Republicans are out of step
Some Republicans still insist that government health care is wrong, and particularly that anything Obama signed into law must end. But congressional Republicans are out of step with the American people. It’s useful to remember that the ACA was originally built on Republican ideas and based on a health care plan signed by Republican Mitt Romney when he was governor of Massachusetts. Their objections are based on grievance politics, not on policy, and we all pay the price.
With Democrats controlling all three branches of government, our country has the first opportunity since 2010 to make substantive changes on health care policy. Instead of defending the ACA from attacks, we get to imagine what a sweeping vision of health care could and should look like.
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Health care as a human right was once a far-fetched notion. But now on the anniversary of the ACA’s enactment and with the backing of the American people, President Biden is quietly making his promise for affordable health care for all into a reality.
We should appreciate how far we have come in the past decade, but the work doesn’t stop here. Biden and Congress have made a promising start. We must hold them accountable and help them finish the job. In the richest country in the world, no lives should be lost due to insufficient profit.
Laura Packard, a Denver-based health care advocate and founder of Health Care Voices, a nonprofit grassroots organization for adults with serious medical conditions, is executive director of Get America Covered, senior adviser to Be a Hero and co-chair of Health Care Voter. Follow her on Twitter: @lpackard