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28 June 2012

Thoughts on Opposition Responses to the Supreme Court Ruling on the ACA

(The following quotes come from CNN, located beneath their article on the Supreme Court Decision on the Affordable Care Act.) 
Mitt Romney, presumptive Republican presidential nominee
"What the Court did not do on its last day in session, I will do on my first day if elected president of the United States, and that is, I will act to repeal Obamacare. Let's make clear that we understand what the Court did and did not do. What the Court did today was say that Obamacare does not violate the Constitution. What they did not do was say that Obamacare is good law or that it's good policy." 

Romney fails to acknowledge that it isn’t the supreme courts place to rule on whether the ACA is a good law or good policy. Numerous independent agencies have written pages on the benefits or lack thereof, and anyone can take the time to read, analyze, and come to their own opinion on the matter. Sadly, too many people rely on agencies like CNN, Fox, etc to tell them how to think, often obtaining skewed and inaccurate information on the impact of the ACA on the public.  

 House Speaker John Boehner
"The president's health care law is hurting our economy by driving up health costs and making it harder for small businesses to hire. Today's ruling underscores the urgency of repealing this harmful law in its entirety."

Speaker Boehner goes a step further than Romney, obscuring the fact that a ruling finding the entire law unconstitutional would have done more to drive up costs, and harm businesses or the economy. The fact is that small businesses are largely eligible for waivers for the mandate to provide insurance (it only affects small businesses with 50 employees or more) and the subsidies created by the law help those accountable for providing insurance, or needing to seek individual insurance through the health insurance exchange.

 Senate Minority Leader Mitch McConnell
"Today's decision makes one thing clear: Congress must act to repeal this misguided law. Obamacare has not only limited choices and increased health care costs for American families, it has made it harder for American businesses to hire."

McConnell, like Boehner, makes assertions unproven by fact. The options available to families have increased, and will continue to do so through the full implementation of the law through 2015. The coverage of larger numbers of young adults and families, with improvements in preventative care will actually serve to save our nation unnecessary health care costs. The fact is that the uninsured and underinsured most often wait until their need for care becomes so acute they must seek services via emergency and urgent care departments. At that point of care, the medical interventions, diagnostic tests, and medications needed are far more costly than early detection, treatment, and prevention will ever be. Conservative leaders, including those above, simply refuse to factor that into the anticipated cost of implementing the ACA.


My own family contends with not one but four different chronic and / or autoimmune conditions. I simply don’t seek care for my own, and barely cover my type 1 diabetic daughter’s expenses, even with Medicaid coverage, namely because many of the supplies and tools are simply not covered by Medicaid. I qualify for bankruptcy as a result of the medical debt I’ve carried (and continue to add to) for over 20 years, should I ever be able to afford such an undertaking. (Don’t read this as I want to – it’s a need, but I digress.) For the first time since I received the first significant medical diagnosis of a chronic illness at the age of 17, I am filled with a sense of hope. Hope that I won’t be forced to add to the mounting medical debt, hope that I might gain a greater quality of life through adequate care.


I don’t believe that the Affordable Care Act answers all of our problems, or provides the best solution. That said, it provides the greatest step towards better, more affordable health care seen in our nation’s history – a fight that is not new. (Truman and his wife championed national healthcare, and he signed the International Declaration of Human Rights, which lists access to health care as such a right, in 1938 on behalf of our nation.) Perhaps more helpful to understanding the benefits of the ACA is to read one doctor’s account of what would have happened had the Supreme Court ruled the entire law unconstitutional. Despite the fact was written for doctors, before the decision was handed down, it helps to highlight just a few of the positive changes. Kevin MD’s blog article is located here, and I encourage the unconvinced to read it. http://www.kevinmd.com/blog/2012/04/chaos-doctors-affordable-care-act-struck.html


We are not done with the fight for truly accessible health care, and between now and 2014, those of us contending with pre-existing conditions, underinsurance, and unfair caps on coverage amount face ongoing challenges. Personally, I cannot wait for the creation of the health insurance exchange and the ability to purchase truly adequate coverage for my children and I, or for the opportunity to seek medical interventions I’ve needed for over a decade. I know so many people, friends and past patients or their families in similar situations. Too bad those like Romney, Boehner, and McConnell are too busy with political grandstanding to understand the future harm they’ve promised to unleash on our nation’s citizens. Then again, they have no idea what it’s like – they and their families already benefit from better health insurance than enjoyed by the majority.