The Patient Protection and Affordable Care Act was passed by both houses of the United States Congress. It was signed by a president who has since been re-elected. It was upheld by a skeptical Supreme Court. Like it or not, “Obamacare” is the law of the land.
So the next step is to try to make it work as well as possible, right?
Wrong, at least according to too many critics.
This fall, the push to expand access to insurance coverage enters a critical period. Uninsured residents can start signing up for health insurance through exchanges that offer group rates and do not penalize people with pre-existing conditions. Those with incomes between 100 and 400 percent of the poverty level will be eligible for federal subsidies to help cover the cost.
That’s a great opportunity for those who can’t get insurance at work and a boon for public health as a whole, say people like Dr. Karen DeSalvo, New Orleans’ health commissioner — as long as people know that they’re eligible and understand how to sign up.
DeSalvo’s office is using a federal grant to reach out to workers in low-coverage industries such as construction, tourism and restaurants, to let them know what’s available and encourage them to enroll.
Sure, DeSalvo works for a Democratic mayor, but she sees the initiative as divorced from politics. She said she’s not advocating for a political point of view, but rather “for people to have good quality care.”
“I’m a public health person,” she said. “I believe that if people have health insurance coverage and better quality care, they’re healthier, they can go to work, go to school, and have a better quality of life.”
Elsewhere, though, the effort to spread the word has run straight into partisan politics.
Among those manning the buzz saws is Rep. Steve Scalise, chairman of the conservative Republican Study Committee, who beseeched the National Football League and National Basketball Association to reject any request by the Obama administration’s to help spread the word through a public education campaign. The idea was based on an effort by the Boston Red Sox to publicize a similar Massachusetts law passed by Republican Gov. Mitt Romney.
But in a letter to the commissioners of both leagues, Scalise, R-Jefferson, scoffed at the Department of Health and Hospitals’ “plans to facilitate and cheer on the implementation of President Obama’s health care law,” and cautioned the leagues against “being coerced into doing their dirty work for them.”
Gov. Bobby Jindal, of course, has pointedly refused to accept federal money to expand Medicaid for those who make too little to qualify for the aforementioned subsidies, and also has declined to set up a state-level exchange. Jindal may go around talking about how states are more efficient than federal government, but in this case he’s content to let Washington do it.
Sentiment on the right is so strong that it’s produced tremendous pressure not to break ranks. That explains why Scalise’s congressional colleague, Rep. Charles Boustany, R-Lafayette, adamantly denied news reports that he’d criticized Jindal’s stance on expanding Medicaid and setting up a state-level exchange — reports that led a major conservative blog to bash him.
Now, okay, obviously Obamacare as a whole remains fraught on all sorts of levels. It’s large, cumbersome and proving enormously complicated to implement, so much so that the president recently delayed the mandate that large and not-so-large employers provide insurance for full-time employees.
That’s left critics feeling empowered and Obama on the defensive. Last week, the president, with good reason, accused “lots of folks in Washington” of “rooting for this to fail.”
Behind the scenes, pressure is coming from a different quarter. With the Oct. 1 deadline to set up the exchanges looming, the White House is scrambling to convince younger and healthier people to sign up — not just because it wants political buy-in, but also because it needs them to balance out the older customers who consume more health care, in order to keep costs and premiums in check for everyone. According to a recent Washington Post story on the administration’s marketing effort, the White House believes its ability to lure those potential customers will determine whether the measure works as designed, or doesn’t.
So, yes, the critics are right that the White House wants this thing to work, badly. There’s a lot riding on the exchanges’ success for some politicians, and on its failure for others. But the underlying, and often-ignored, question is — regardless of whether you believe in Obamacare, shouldn’t everyone know their rights? So ask yourself this: Is it more political to promote the program — or not to?
Stephanie Grace can be contacted at firstname.lastname@example.org.