The Affordable Care Act: Beyond the Shouting

Taken the July/August 2016 issue of The Women's Health Activist Newsletter.

Opponents of government involvement in health care attack the ACA, claiming that it’s “hurting families,” the nation’s “biggest job killer,” and that premiums are “going up 35, 45, 55 percent.” These claims are all false, but that hasn’t stopped opponents from repeating them over and over again — often in a loud voice at a rally. But, just saying something in loud voice doesn’t make it true. As health care activists, we know the facts: the ACA has helped millions of families get covered, hasn’t led to job loss, and premium increases are mostly in the single digits.

Opponents of government involvement in health care aren’t the only ones shouting about the ACA, however. People who share the NWHN’s view that health care is a human right are also criticizing the ACA. It doesn’t do enough — “Obamacare was a small victory for the uninsured.” It’s not always affordable — we need to “lessen out-of-pocket expenses for consumers purchasing health insurance on the Obamacare exchanges.” Supporters of government involvement in health care aren’t misstating the facts, but sometimes they’re emphasizing what’s missing from the ACA, at the expense of recognizing what it has meant for peoples’ lives.

People like Leila Blogden, who was able to get her daughter Peyton’s epilepsy under control after Maryland Women’s Coalition for Health Care Reform helped her get covered through expanded Medicaid. And people like La’Tasha Mayes, founder of New Voices for Reproductive Justice, who spent years advocating for health justice, but couldn’t get her pre-existing conditions covered until the ACA went into effect.

Women like Leila and La’Tasha are among the millions whose lives have been helped by the ACA. Even though the ACA is far from perfect, and we want improvements as soon as possible, it’s important to recognize how much has happened since 2013.

According to the National Health Interview Study, the uninsurance rate fell to 9.1 percent in 2015 —the lowest rate ever recorded. Now, 17.7 million people, including 9.5 million women, are covered through the ACA’s health insurance marketplaces; another 14.5 million are covered through expanded Medicaid. Racial and ethnic coverage disparities are beginning to shrink, too. Since the beginning of ACA implementation, uninsurance rates have declined 11.8 percentage points for African Americans, 11.3 percentage points for Latinos, and 7.3 percentage points for Whites. Nearly all women who have been helped by the ACA are covered by plans that don’t discriminate against them on the basis of their gender. New anti-discrimination regulations announced by the Obama administration in June mean that no one in the health care system (providers or insurers) can discriminate against any person based on gender, gender identity, or sexual stereotyping. That’s good news for LBGTQ folks as well as for women.

We know a lot more needs to be done. The NWHN believes that every person has a right to health care, including immigrants; that cost should not be a barrier; and that health care delivery needs to be reformed, as well. The NWHN has historically supported single payer approaches to health care, and we continue to support proposals for systems, such as Medicare for All, that would move America in that direction.

The NWHN doesn’t shout about the ACA. Well, maybe at Supreme Court rallies – but mostly not. We know we’re going to make the progress we need by sticking to our values, being honest about the facts, and building on the gains we’ve already made. We hope you’ll join us!

Cindy Pearson was the NWHN’s Executive Director from 1996 to 2021. One of the nation's leading advocates for women's health, Cindy often testified before Congress,  NIH and the FDA and was frequently featured in the news as a consumer expert on women’s health issues. When she retired, Cindy received a Congressional Resolution in honor of her outstanding contributions to the health of women and girls.

Read more from Cindy Pearson.