Health care was and continues to be upfront and center in the world of political boxing, also known as elections. When the bill was debated, citizens went to their politicians with pleas for more coverage, less coverage, or for no bill at all. There were rampant accusations. There were false claims that it was done in secret by only one party, although committees had hearings and it was posted. Workers hated some provisions; businesses hated others. Insurance companies hated coverage requirements, although they loved the mandate part that would give them new customers. Others hated it precisely because it gave insurance companies so many new customers, and they preferred that it be like England's, where it is government-owned and run. Many just wanted it to be like our existing Medicare, and that's what I would have preferred myself.
It did have the support of leading organizations in the health care industry, groups such as the American Medical Association, the American Cancer Society, and so many other groups that actually work directly with patients. The Small Business Majority, AARP, and many others also endorsed it.
The now-speaker of the House, John Boehner, terrified seniors by releasing a statement that was false and chilling. He said, "this provision may start us down a treacherous path toward government-encouraged euthanasia if enacted into law." There are still some who do not realize that the bill simply allowed doctors to be reimbursed for their time by Medicare if the patient and the doctor wanted to discuss near-end of life treatment choices. And on it went. There were death threats, fights in town halls, letters and calls. There were protests in cities everywhere. (In Manchester, they carried a dummy on a rail down Elm Street to my office and taped tea bags on the door.) It was not easy, and the debate certainly was often not civil, but the bill finally did pass and was signed into law.
So, how's it working out so far? There are many snags that still need to be worked out. I said it wasn’t perfect. For example, there was a provision that was too burdensome for small business. That was repealed by a bi-partisan vote. However, I believed it would be a huge help for the average American. And it has been.
The sky did not fall in. People kept their doctors. Seniors get free preventive care, and get a 50% discount on brand name drugs if they have hit the so-called donut hole. Small businesses are now eligible for tax credits. Being female is no longer considered a pre-existing condition. Children with pre-existing conditions are covered, and we stopped annual or lifetime limits. So many families were hurt in the past by those limits, and I was very pleased that these provisions were included.
Children can stay on a parent's policy until age 26. This helps health care providers, since fewer bills will go unpaid. Nonpayers costs each family more than $1,000 a year extra for insurance. USA Today talked about the new insurance mandate in an editorial, entitled "Why that 30-year-old should be required to have insurance." They wrote, "...the mandate was born as a conservative response to President Clinton's much maligned health reform proposal in the 1990s. Back then, many Republicans argued that people shouldn't be able to freeload by expecting everyone else to pay their bills if they end up at hospitals...." This mandate should have Republican support when it begins in 2014, especially since there will be subsidies for people who need help to get the insurance.
Other good results are showing up. Medicare Advantage Premiums actually fell a little and benefits stayed the same, even though the health care law reduced payments to providers because their costs were higher than traditional Medicare, and taxpayers were being hit with the extra costs. That is where the so-called Medicare cuts were. There were no cuts to traditional Medicare, and seniors now see that the health care bill actually was a big help.
There are still legal challenges in Courts, insurance companies are still hiking premiums, and there are still many questions and controversies to settle. But the initial results look good, and the provisions already in effect have been a great help to the people who need health care in this country. And that includes all of us. Providing access to health care was morally and economically the right thing to do, and the sky didn’t fall in after all.