30 Million Forgotten

Capitol Hill


By Tara Bansal. 

On October 1st, as the government shut down, a main provision of Obamacare officially launched. The irony here is overwhelming: first, the cause of the shut down- contention over Obamacare – is now irrelevant yet Congress remains out of session as Republicans try to stop a train that has barreled full steam ahead. Second, this bill was created to breathe life into domestic policy but is coming to fruition in a clearly decrepit, broken system. And third, those specifically meant to be benefitted by this legislation are the ones being ignored by it.

Until last Tuesday, the United States was one of only three developed countries without some form of government-subsidized universal healthcare. Yet, the US government was still spending more per capita on health expenditures than any other nation and routinely falling in many health metrics, implying inefficiency in the system. Additionally, an aging demographic suggested that Social Security would soon be underfunded. Advocates of a universal healthcare policy argued that Obamacare had positive implications for not only the uninsured but also the economy. 

Thus, on March 21st 2010, the bill known more formally as the Patient Protection and Affordable Care Act was narrowly passed by the US Congress with a 219-212 party line vote, every House Republican opposing the bill. Before President Obama had even signed it on March 23rd, the GOP introduced the first of forty-one subsequent attempts to repeal it.

It was this obstinacy that resulted in the shutdown of the US government. Because every Republican-backed spending budget contained stipulations to defund parts of Obamacare, a divided Congress was dismissed until a clean budget bill could be passed by the Democrat-controlled Senate. Every day, as many Republicans continued to support the comprehensive and unrealistic defunding of Obamacare, millions of Americans legitimized it by registering in the government marketplace. The irrational lack of compromise notoriously attributed to conservatives such as Senator Ted Cruz and Speaker of the House John Boehner eclipsed the more moderate actions of some members of the party and perpetuated the notion of a dysfunctional Congress.

As Obamacare begins to go into effect, it’s clear that even without a repeal, Congressional Republicans have been able to at least partly reduce the impacts of the bill. Due to the 2012 Supreme Court Case, National Federation of Independent Business v. Sebelius, while most provisions of Obamacare were deemed constitutional, the court gave states the option of refusing to expand Medicaid to cover more of those under the poverty line; twenty-six states with Republican representatives have already rejected an expansion. Thus, many of the economically disadvantaged in these states neither qualify for Medicaid nor make enough to buy healthcare through the federal marketplace.

The irony is that this population – nearly 30 million Americans – accounts for a majority of America’s poor, uninsured minorities and single mothers that the bill was initially meant to help. Concentrated mainly in conservative, Southern states, over 80% of these people are US citizens but won’t make enough to afford US health insurance in their lifetime.

Apart from the obvious harm to a state’s citizens, what’s even more ridiculous is that under Obamacare, the federal government, which currently pays for only 57% of Medicaid funding, will fully cover the expansion and subsidize the states entire contribution. States could save an estimated $18 billion from 2013-2022, not to mention local and state governments will no longer have to spend on uncompensated medical care. Refusing federal subsidies is a political statement from Republican governors that not only hurts the uninsured Americans in their states but also hinders economic progress.

That is not to say all conservatives oppose the expansion of Obamacare. Governor Rick Synder (R-MI) was the only conservative governor in 2011 not to sign a letter by the Republican Governors Association calling for a repeal to the healthcare bill. Meanwhile Governor John Kasich (R-OH) has called on his party by invoking the question WWRD- “What Would Reagan Do?” In his editorial for USA Today, Governor Kasich reminds Americans of how Medicaid expansion has had historically positive contributions:

Leaders in the states that have decided against expanding have often invoked Reagan conservatism as the reason to oppose extending Medicaid health care coverage to more people. After all, doesn’t Reagan embody modern conservatism? He cut taxes, cut government red tape and fought the growth of entitlements. Yes, he did all those things. However, he also expanded Medicaid, not just once but several times.

For example, in 1986, President Reagan let states add poor children and pregnant women to Medicaid. And after learning that disabled children could receive Medicaid care only in hospitals and nursing homes, he let states provide them care at home also. Ohio resisted both expansions for a decade but saw powerful results for some of our most vulnerable citizens once we made them.

The problem is that more moderate politicians- whether conservative or liberal- are becoming more rare. The fact that nearly 60% of the uninsured are still denied access to basic healthcare after the extensive conflict to develop, pass and inaugurate Obamacare is disappointing and indicative of the increasing difficulty of a divided Congress.

The 113th Congress has been called the most “ineffective Congress ever” with only 22 bills passed in its first session. Even the 112th Congress, which previously held the notorious title, passed 90 bills in its first session and Truman’s “Do Nothing Congress” in 1947 passed nearly ten times the legislation as ours. Dissent is inherent in any political system but the extremist nature of political parties today alienate one another and remove the mere possibility of compromise. Parties today are unparalleled in discipline and ideological coherence- no longer do they boast a wide range of beliefs as moderates are few and far between. If politicians started working with each other, rather than against each other, they would be vastly more successful in their aims.

The seemingly eternal conflict of a split government has vastly negative implications in policy. Obamacare is like a child that one parent does not want. Until it is truly embraced, its full potential will never be explored. 

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