Authoritarianism is the greatest public health risk
'Sabotage' of the Affordable Care Act is just political rhetoric
In a recent House committee hearing, witnesses came forward to say that if the ACA is invalidated, important patient initiatives would be eliminated. They brought up the initiatives pertaining to combatting the opioid epidemic, curtailing the AIDs epidemic, and advancing kidney health. Perhaps they didn't know that these were all put in place by the Trump Administration.
Repeated claims of sabotage of the ACA by the Trump Administration fall flat because of these important initiatives put in place by the president. Although the president has chosen to not defend the ACA in the Texas v. Azar case, he has made numerous strides to make available options to help Americans who require coverage suited to their needs, as well as help for those with chronic conditions.
That's why each of these initiatives is important.
Recently, the Centers for Disease control and Prevention (CDC) released a report demonstrating that the work of the administration's opioid commission is producing results. Preliminary data shows that reported drug overdoses declined in 2018 by 4.2 percent. This is the first-time overdoses have gone down, year-to-year, since the crisis began. Although some states showed an increase in deaths related to overdose, overall national numbers are moving in the right direction.
According to the Department of Health and Human Services, "President Trump announced one of the most important public health initiatives in history: ending the HIV epidemic in America."
The initiative "will work to reduce new infections by 75 percent in the next five years and by 90 percent in the next ten years" according to the HHS Secretary, Alex Azar, in the Plan for America dedicated to ending the HIV epidemic. The HIV epidemic is a biomedical challenge as well as a social one which is why it is so important to address this issue that disproportionately impacts people of color.
The costs associated with kidney disease and transplantation can be extraordinary. Furthermore, the medication that is needed to sustain the transplant can be very expensive. According to a press release from the Centers for Medicare and Medicaid Services, "The proposed ETC Model would include protections for both beneficiaries and participating ESRD facilities and Managing Clinicians." The goal through this effort is to reduce the number of Americans with end-stage renal disease by 25 percent by the year 2030.
The millions of very poor and elderly in this country have a safety net for their medical care. Not so for the middle class, which has been harmed most by the increase in premiums and deductibles in recent years. The head of the Kaiser Family Foundation (KFF) made the statement recently that "the system increasingly doesn't work for this group in the middle, these people may have health insurance... but they can't pay the bills."
The Affordable Care Act was meant to help people get coverage, but the unintended consequence (as is often the case with government over-reach) was that it made health care unaffordable. Deductibles have more than tripled, and - according to a recent poll by KFF and the LA Times - these deductibles are what most middle class Americans are angry about. The article goes on to say, "many health plans being sold on the law's insurance marketplaces have very high deductibles, mirroring the run-up that has happened with job-based benefits."
Some continue to claim that the ACA increase in premiums is due to some sort of sabotage, but a study by KFF has shown otherwise. The study clearly states that, "premiums in much of the country are holding flat or decreasing a bit... On the exchange, meanwhile, subsidized customers will continue to pay sliding-scale premiums based largely on their incomes, and so the amount of premium they pay is mostly unaffected by the repeal of the individual mandate and expansion of short-term plans."
Crying sabotage appears to be more of a political tactic than a real policy solution that will help the American people. The evidence shows that far from sabotaging health care, the Trump administration has put into place initiatives that will improve people's lives.
David Balat is the director of the Right on Healthcare initiative at the Texas Public Policy Foundation. Follow him on Twitter @DavidBalatHC.