As the deadline for uninsured Americans to sign up for health coverage looms, the political war over Obamacare is increasingly disconnected from people’s actual experience of the Affordable Care Act.   

Despite a disastrous roll-out in October, more than 5 million people have obtained coverage through new insurance exchanges. States have covered almost 2 million previously uninsured or under-insured low-income Americans through Medicaid expansion. Seniors are saving money on prescription drugs. People are no longer locked out of the system because of pre-existing conditions or dropped by their insurers when a health crisis strikes. Overall, the cost of our healthcare system is coming down, in part due to reforms that improve how health care is delivered. Lives are being saved.


But the job is far from complete. Governors or legislatures in 25 states have thus far refused to accept federally funded expansion of Medicaid, 16 percent of Americans remain uninsured, and the health care exchanges in some states are still not running smoothly. 

Politicians who have vehemently refused to participate in the Affordable Care Act are hurting all of their residents, who pay higher premiums and medical costs as a result. However, the greatest harm is done to low-income communities, particularly African-American and Latino families who are disproportionately uninsured and unable to access high quality medical care.

Our organization, the PICO National Network, mobilized thousands of religious leaders to shape health reform to meet the needs of lower-income families, and we’re working with business, labor, faith and civic leaders to ensure that it works for every American regardless of economic status, race or place of residence.

One of the most promising efforts we are involved in is a five-state project that is lowering health care costs while improving care by focusing on better meeting the needs of the sickest people in communities where chronic health problems are most common and access to quality care is least equitable. Religious congregations are often the center of community life in these places.

Much as prophets attended to the physical ailments as well as the spiritual health of their followers, clergy are working to deliver holistic care to their communities. Because faith leaders are deeply trusted by their flocks, congregations are crucial routes to enrollment in Medicaid and other affordable health insurance plans in the insurance exchanges. They are also working with innovative healthcare providers to set up community-based care in areas where there are few if any doctor’s offices or clinics.

In our nationwide network of congregations, we see that politically motivated decisions to turn down federal Medicaid dollars are  harming families. In places like New Orleans and Orlando, many low-income people in our congregations fall into the Medicaid “coverage gap.”Unable to afford primary care, sick children and parents wait at home until health problems become too severe to tolerate, then go to crowded and expensive emergency rooms. Preventive care is neglected, and people die as a result of serious conditions going undetected until it’s too late. People face these circumstances because of unjust, immoral and shortsighted decision by politicians in their states to put politics over the needs of people.

In places like Oakland and Denver, families at the same income level are covered by Medicaid and have vastly improved access to quality care. The constant anxiety of having no safety net has diminished. People who would otherwise get sick and die get the treatment they need.

Is the life of a Louisianan or a Floridian any less precious than that of a Californian? Is it of less value than that of a governor or a state senator? We must insist that our elected officials treat all of God’s children with dignity and respect instead of playing political games with people’s very lives.

In 1966, Dr. Martin Luther King, Jr., said in a speech to the Medical Committee for Human Rights, “of all the forms of inequality, injustice in healthcare is the most shocking and inhumane.”

Almost half a century later, this oppression has diminished significantly thanks to Medicare, Medicaid, CHIP, and now the Affordable Care Act. What remain are reprehensible gaps in health care coverage for people in low-wage jobs, and particularly African Americans and Latinos.  We also know that rising poverty and inequality worsen health problems. This is not a moment for rest, but an opportunity to recommit ourselves to implementing the law for all Americans, and to overcome the unjust and shortsighted choices of politicians who are failing the moral test that King challenged us to meet.

Whitman is deputy director of PICO National Network, a faith-based organizing network.