Across the country, communities are struggling with the rising cost of living. They are worried about failing banks. And 40 percent of people in America, where health care is already horribly expensive and inadequate, are being forced to cut back on basic needs as a result of medical debt.
Instead of trying to lessen the financial burden on the average household by making the wealthy and corporations pay their fair share, opponents of the Affordable Care Act (ACA) are once again trying to take health coverage and care away from people who are already struggling to make ends meet.
The previous tactic of taking a wrecking ball to the entire ACA through the courts or legislation has failed. What we see now is a pivot to a more dangerous and stealthy strategy of death by a thousand cuts.
This new strategy is at work in the halls of Congress, where the House Republican leadership is threatening to hold our economy hostage if a deal isn't made to take away Medicaid from people who need it. What they're proposing threatens basic health coverage for millions of people with low-incomes. They won't say it because it's so unpopular, but it's just another attempt to cut Medicaid and it would threaten coverage for 21 million people. As a result of discriminatory barriers to economic security, Black and Latinx people are disproportionately harmed by Medicaid cuts.
Despite clear evidence that it hurts people, House Republican leaders are pushing a policy that would force people with Medicaid coverage to overcome a host of new barriers in order to keep their insurance. They falsely claim it's about making sure people with Medicaid coverage are working— despite the wealth of evidence that they are, n ever mind that insurance is necessary to being healthy enough to work . Even more, access to Medicaid is one of the best tools to prevent people from accruing medical debt. By cutting access to Medicaid, these policies open the door to more people falling into debt which will hold them back from living healthy, full lives.
These attacks on people's health care have not been limited to Washington. In recent weeks, we have seen this plan at work in courts, and in state legislatures and governors' offices from coast to coast.
In the courts, we see it through attempts to ban medication abortion, preventing access to vital abortion care— an effort that could have implications for accessing dozens of other medications. We also see it with the new litigation strategy of attacking the ACA piece by piece, including a recent lawsuit to get rid of critical no-cost preventive care protections for more than 100 million people. This includ es HIV prevention medication (PrEP), cancer and mental health screenings, maternity care, and more. And we see it at the state level in the form of advancing countless abortion bans and denying trans people health care.
Throughout our nation, people across identity and experience are waking up to the reality of this new strategy — which harms community health and wellbeing, the financial mobility of working-class families, and the integrity of our nation. It is a strategy that is taking our nation backward by taking power and control away from individuals, families, and communities . And we need the Biden administration and Republican and Democratic members of Congress to listen to their constituents, stand up and fight back. Our message is clear: Taking health care away cannot be a political bargaining chip.
The ACA is now 13 years old and well woven into the fabric of the country. It is more popular today than at any point in its history. And opponents know it. The number of uninsured nonelderly individuals dropped from more than 46.5 million in 2010 to fewer than 27.5 million in 2021. Which is why more than 100 days into their new House majority, there have been no efforts to repeal or replace it.
The old approach, repealing the ACA as a whole, was not only deeply unpopular but was easy for people to understand and for communities to organize against. But don't be fooled. Just because the tactics have changed, the ultimate goal has not. And this new strategy of death by a thousand cuts is just as dangerous as full repeal of the ACA and far more targeted at communities of people who can least afford to lose their coverage and care.
And that is the whole point.
Emily Stewart is executive director of Community Catalyst.
The views expressed in this article are the writer's own.
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