Monday, February 05, 2018

We won, now what? My account of Health Action 2018 at Crooked Media

The Affordable Care Act's passage through 2017 was a bit like Odysseus' ship sailing past the six-headed monster Scylla: six men gone, but the ship sails on (only to be destroyed by thunderbolt a few episodes later, but never mind that part). 

Health Action 2018, Families USA's annual confab of healthcare activists, was largely devoted to taking the measure of the political power somewhat miraculously tapped by a wave grassroots passion and action that staved off repeal -- and groping toward a path by which Democrats can build on or move beyond the ACA in years ahead.

I have an article up at Crooked Media that examines what kinds of next steps - or false starts -- the conference conversations point toward:

No one at the event allowed themselves (or anyone else) to forget that a wrecking ball still looms over the ACA and Medicaid. As Anne Pfrimmer of the SEIU warned, Senator Lindsey Graham is  “shopping Graham-Cassidy [a bill that dismantles the ACA marketplace and guts Medicaid spending] every day, and there’s 48 votes for it.” Yet the conference was focused in large part on taking stock of the power that a broad array of activists had united to wield in 2017—successfully staving off the dismantling of the ACA and evisceration of Medicaid, both written into Republican bills that came within a hair’s breadth of passage.

But where exactly would a new Democratic offensive on healthcare land? If Democrats take power in 2020, will they converge on a way to extend health insurance to the 28 million who still lack it, reduce out-of-pocket costs for the estimated one third of insured Americans who have trouble paying medical bills, control costs to make those goals feasible, and simplify the dizzying array of programs and markets that that currently provide healthcare coverage? Will they merely look for ways to shore up the ACA marketplace (reinsurance, a public option, more generous subsidies), look to remake the system all at once, via some form of Medicare for all, or seek a sequence of incremental changes designed to fundamentally transform the current system? 
 I hope you'll take a look at how those questions were addressed at HA2018.

A couple of postscripts. First, I have a bit of a nagging conscience in that the conference was quite deliberately focused in large part on inequity based on racial and ethnic discrimination in U.S. healthcare access, and this article only glances at those issues in the negative, in Chris Jennings' declaration that "equity doesn't sell" in the U.S. political marketplace. Hence this outtake focused on two plenary sessions devoted to equity issues. Also, the emotional high point was a panel of leaders of effective activist groups, as glanced at in this post.

Second, a personal note: I've rarely had the pleasure and pain of being seriously edited. Brian Beutler induced me to restructure a chronological walk through conference sessions into a "where did it all point?" essay. I'm reminded of a of a professor in a grad course on teaching freshman composition course who posited: "Our job is to wean them off chronology" (or was it "off narrative"?). I'm a bit old to be weaned, but in this case I needed it.

1 comment:

  1. Thanks for your summary of an important meeting.

    Regarding your list of challenges that Democrats would face in 2020:

    1.The Democrats cannot cut health care costs, because that means cutting health care incomes and jobs. The federal government will do nothing that explicitly causes unemployment.

    2. The 28 million uninsured include (I believe) about 5 million poor people in the states that did not expand Medicaid. Who are the other 23 million? If they are illegals, I don't care if they are uninsured. (and I am a liberal). If they turn down insurance that is subsidized, I assume they are healthy and I don't care that much.

    3. To sustain the ACA, the Democrats simply must provide more to the middle class. Subsidies can be tiered to gold coverage, and the 400% ceiling on subsidies must be removed. Blomberg and Holohan costed this out in 2016 and came up with $22 billion extra per year. This I would care about.

    Finally, do you know where I can get a YouTube or other recording of the conversation with Jennings and Rosen? thanks