Despite the rhetoric, it remains unclear what policy makers intend to do with the Affordable Care Act. Repair, repeal, replace or remake are all options at this point. As they take action, I challenge them to meet this test: any new health care law must increase the number of people who have access to affordable primary health care.
More than 20 million people have gained health insurance of some type through the ACA. Any new law, or variations on the old one, should add to that number, while also solving the problems of rising premiums and high deductibles that still threaten to put health care out of reach for too many.
Families without health insurance are often one diagnosis away from a health care emergency that puts them at risk for personal and financial ruin. If we pull back on affordable primary care, more low-income families will fill hospital emergency rooms–an expensive last resort for which the rest of us pay the bill. Today, 28.5 million people in the U.S. remain without insurance. Repealing the ACA without a suitable replacement is expected to add another 18 million to the ranks of the uninsured within a year. Some estimates project the number of uninsured will rise to nearly 60 million.
As the debate continues in Washington, I think about the struggling, low-income patients who rely on the 1,000 free clinics and safety net health centers my organization supports nationwide, including those we operate ourselves in our home state of Connecticut. They are people like Mark in Ohio who lost his coverage when his factory moved out of town, and Delores in Texas who suffered a heart attack and a stroke soon after retiring from local government. I worry about them. Will a new health law assure them access to quality care, or will many others find themselves in similar circumstances?
I worry, too, about the free clinics — often staffed by volunteers — that provide care to those without insurance. Will their burden be relieved as more people find access to affordable health insurance, or will their doors be flooded with millions of additional patients who have lost coverage?
For nearly 25 years I have worked to improve access to quality health care for the most marginalized citizens of countries across the globe, including our own. I have learned this: good health opens doors to opportunity. Poor health, often caused by lack of access to affordable primary care, often shuts that door.
This is not a political issue. It is a human one. Every man, woman and child deserves to lead a healthy life and the opportunity to reach their full potential.
The ACA is far from perfect — the lack of competition in some states and the high deductibles cause real pain for low-income families. We’ve had patients purchase insurance only to return to our free clinics seeking care because they cannot afford the deductibles. But the ACA was a first step to address the health needs of the poorest among us. As new legislation is introduced, I challenge lawmakers to meet my test and ensure Mark, Dolores and others have access to the care they need.
To read Americares statement on repeal of the Affordable Care Act click here