July 3, 2012 — Last week, the U.S. Supreme Court rejected efforts to invalidate President Obama’s historic health care law that will extend health insurance coverage to nearly 30 million Americans between now and 2014. Right-wing opponents of the legislation asked the Court to throw out the law enacted in 2010 as an unconstitutional use of power by the national government. By a 5-4 vote, the Court upheld the legislation, preserving reforms that are already benefiting NALC members, including a provision that allows children to stay on their parents’ health plan until the age of 26 and a provision that eliminates the so-called ‘donut hole’ in the Medicare Part D program that saves seniors thousands of dollars on prescription drug costs.
The Court’s decision means that progress toward universal health coverage in America will continue. But it also sets the stage for the 2012 elections that will ultimately decide whether all citizens in the United States will finally be guaranteed insurance against illness and injuries. Republicans have vowed to repeal the Obama health care law if they win control of the Senate and the White House in November. Mitt Romney, the Republican nominee for president, has said he would move to repeal the law on “Day One” of his administration if he wins. And the GOP-controlled House of Representatives has scheduled a vote to repeal the law on July 11, even though it already voted to repeal the law earlier this year – and despite the fact that there is no chance that the Senate would follow suit this year.
The GOP opposition is ironic since the Obama plan is modeled on a plan developed by the conservative Heritage Foundation in the early 1990s that Republicans advocated as an alternative to President Clinton’s reform plan. That Heritage plan also served as the blueprint for the bipartisan health care law adopted in Massachusetts when Mitt Romney was its governor.
NALC President Fred Rolando noted that the decision was a victory for working people, but warned that the victory would not be complete until November: “The Court did the right thing today,” he said, “but this fight is not over – working people and their unions must spare no effort to elect progressive representatives to ensure universal health insurance for all will finally be achieved.”
For decades, America’s hybrid public-private health care system has left as many as 15% of Americans without insurance, relying on emergency room services and inadequate public health facilities for even basic health care. The system’s inefficiency has raised America’s health care costs to twice the level of most other advanced countries. Letter carriers and other workers with insurance coverage have been paying for the health care costs of the uninsured through higher premiums for decades. The Obama health care law, though imperfect, will help address these serious flaws and end the greatest source of inequality in American life. It will also end the problem of free riders by imposing an individual mandate and prohibit the worst abuses of the private insurance market (pre-existing condition clauses, annual and lifetime caps, etc.).
The Affordable Care Act of 2010 was the culmination of a 75-year struggle by the American labor movement and progressive Democrats to secure health care for all Americans. President Franklin Roosevelt proposed to expand the universal state pension scheme (Social Security) to cover health care costs in the 1930s but Republicans blocked President Truman’s attempt to do so in the 1940s. Progress was made in the 1960s when President Johnson created the Medicare program for the elderly and the Medicaid program for the poor, but those programs still left millions of working Americans without coverage if their employers did not offer a health plan. President Clinton proposed universal coverage through an employer mandate in the 1990s — but Republicans objected to requiring businesses to offer coverage, claiming to favor a system based on an individual mandate that required citizens to buy private health insurance on their own if their employers did not offer coverage.
The Obama plan enacted in 2010 provides for both an employer mandate (for firms with more than 50 employees) and an individual mandate to buy insurance, but offers both workers and small businesses financial assistance to pay for premiums and sets up regulated exchanges that requires insurance plans to compete for enrollees at the state level. Although much of the labor movement favored a public “single-payer” plan like Medicare for all citizens, the complex Obama plan gained widespread support among unions as a huge step forward for millions of Americans.
Most Republicans have shifted sharply to the libertarian right and now no longer support universal coverage at all. Talk of “repeal and replace” has morphed into simple “repeal.” The GOP leadership offers empty, poll-tested jargon about “patient-centered” health care and “common sense” reforms to disguise the fact that they have no plan for affordable, universal health care. Indeed, Republican Senate Leader Mitch McConnell admitted that covering the 30 million Americans who are uninsured is “not the issue” as far as he is concerned.
Over the past two years conservative Super PACs funded by billionaires and large corporations have spent a quarter billion dollars to spread disinformation about “Obamacare,” driving support for the law downwards even as its individual provisions garner strong support. But once Americans realize that group coverage at work satisfies the unpopular “individual mandate” and that ending the abuse of insurance by free riders who don’t buy insurance until they get sick will hill help reduce inflation in health care premiums, support for the law is expected to grow.