Improve ACA, don’t kill it

When I became a doctor, I went to work in an emergency room that admitted and treated the kind of hardworking, low-income farmworker families I grew up with. For many of them, the ER was their first and last resort after avoiding the doctor for years because they had no health insurance.

We didn’t check a patient’s political affiliation before treating them. I didn’t check the party affiliation of the other doctors and nurses, either, and they didn’t ask me for mine. Rather, we worked together as a team, following through on the Hippocratic Oath we had taken to treat patients to the best of our ability and, above all, to “do no harm.”

I treated patients before the passage of the Affordable Care Act, and I treated patients after, just as the legislation was beginning to take effect. I noticed firsthand that many patients stopped fearing the cost of their ER visit as more were covered by insurance. When they pulled out their insurance cards, I could tell they felt peace of mind.

If only politicians were required to take an oath to do no harm. Since gaining a majority in Congress, most Republicans have been actively working to bleed the ACA dry so that it will fail, thereby fulfilling their own prophecy. They voted repeatedly to repeal the law and sued to stop it in court.

Now that they have full control of government, they’re trying to sabotage it.

After Republicans pulled Trumpcare from the House floor last month, President Trump responded with a blame-filled diatribe in the Oval Office — 10 minutes of finger-pointing in which he offered up the cynical hope that our health care system will “explode.” The president of the United States actually stated that letting the health care system “explode” was “the best thing we can do politically speaking.”

More recently, the Trump administration has stopped promoting the open-enrollment period for health insurance plans, a move that is now being investigated by the Office of Inspector General in the Department of Health and Human Services. The idea, apparently, is that if people don’t know by what date they need to sign up for a plan, they won’t enroll, fewer people will be covered, premiums will rise for everyone else, and the administration will have even more grounds for saying the ACA doesn’t work.

Coupled with the absurd failure of Trumpcare, these destructive moves lay bare what many of us suspected all along — the Republicans aren’t interested in improving the ACA; they’d rather attack it for political gain. Trump and the Republican leadership have been fundamentally dishonest to the American people for the purposes of winning votes and securing power. This is exactly what disgusts voters about Washington.

With the right wing up in arms over their failure to repeal and replace the ACA, Republicans are sure to try again. But they seem to have learned no lessons from their first attempt. They continue to show no intention of reaching across the aisle to work on commonsense solutions.

According to some policy experts, the Trump administration could immediately reduce the size of deductibles and other health care costs for low-income Americans by permanently funding cost-sharing reductions — federally subsidized discounts that Republicans have filed lawsuits to prevent. Republicans could also instantly repair the ACA’s risk corridor provision, a program that helped insurers to share risk and offset losses, and which Republicans effectively undid in 2014, driving dozens of insurers out of the marketplace. Unfortunately for the American people, Trump has made it clear that these solutions are not in his political interest.

To the White House and Republican leadership: When are you going to get it? Even after years of attacks and sabotage, Americans want the Affordable Care Act. They want it to work, and they want Republicans and Democrats to work together to make it better.

You are doing harm to real people for your own political gain. You’ve undercut the ACA every step of the way and now you own it. You claim you want a health care system that covers more people and reduces costs, and that’s what Democrats have been working to achieve. When you’re ready to get serious, take an oath to do no harm and quit the sabotage and partisan games. Only then can we work together to help people.