Access to affordable health care is essential

For more than a century, many U.S. presidents have tried and failed to pass meaningful national health care reform. Only within the second decade of this century did we finally do so. The Affordable Care Act, or ACA, is a remarkable achievement that has already benefited tens of millions of Americans.

Since I was part of the regional program, so much has been accomplished. Statewide, more than 600,000 adults were newly enrolled on state Medicaid. And nearly 170,000 people signed up for individual plans on the Health Benefit Exchange, with the majority of these qualifying for financial assistance. With this accomplishment, much remains to be done. While Benton and Franklin counties saw a decrease in the number of uninsured, these counties still have an uninsured rate much higher than the statewide average.

Many people’s lives have not only improved but actually been saved by having comprehensive health care coverage. I could tell you many stories. The young woman with breast cancer who wanted to have her daughter covered before she passed away. The man with a seizure disorder who convulsed on our office floor because he could not afford coverage previously. The mother who gave half her income to her son so he could purchase insulin for his diabetes because he was not previously eligible for coverage. These and so many other cases are testimony to the importance of having affordable health care coverage.

The ACA has also brought positive changes for the health care system. Hospitals in Washington had written-off more than a billion dollars each year in uncompensated charitable care, provided to people who could not afford to pay. But during the first year of open enrollment, charity care decreased 34 percent thanks to expanded coverage. Many struggling health care institutions have regained their financial footing through better reimbursement for those in poverty.

The ACA has also led to the growth of local facilities. One of our local health centers, Tri-Cities Community Health, has expanded its medical, dental and behavioral services, and has added a new vision practice, along with staff, all to serve the wave of people newly covered.

Health care reform in Massachusetts (aka RomneyCare), begun in 2006 and the genesis for the ACA, has shown what the effect of increased coverage can have on population health. Within that state, researchers discovered improvements relating to physical health, mental health, obesity, functional limitations and more after the law was enacted. But interestingly enough, they also found improvements in consumers’ financial health, including improved credit scores, reduced debt burdens and a 20 percent decrease in personal bankruptcies. This suggests that being healthy relates to being wealthy.

Today, the president and majorities in both houses of Congress have promised to repeal the ACA wholesale, while maintaining some if its popular provisions. Washington state’s experience with health care reform can offer a history lesson. Back in 1993, the state Legislature passed a comprehensive health care law that had many similarities to the ACA. Backlash to the 1993 law led to subsequent Republican legislative victories statewide. Republicans campaigned on ditching the unpopular parts of the law, most specifically the individual and employer mandates. But they kept the ban on denying insurance for pre-existing conditions. The result was an individual insurance market that went into a tailspin. Without the individual mandate in place, only sick individuals bought insurance. By the end of the 1990s, no insurer was issuing individual policies in Washington because of the financial risk. Are we about to repeat history?

Repealing the ACA is not the solution. And more needs to be done to cover those who have not sought health care coverage. As a country, if we are to pursue happiness, then this must mean securing our basic needs. We cannot claim to be free if our basic needs are not being met. One of the most basic needs of any individual is access to affordable health care.

This story was originally published January 24, 2017 at 4:40 AM with the headline "Access to affordable health care is essential."