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Obamacare: The Lost Narrative

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Amidst all the gloom and doom about the Affordable Care Act is the Sunday Washington Post story highlighting the state of Kentucky's smooth sailing in signing up thousands of state residents, many of them the working poor, who will be getting health care for the first time in their lives. Kentucky's Democratic governor has made this possible by accepting an expansion of Medicaid coverage, and it's completely funded for three years by the federal government under the ACA.

A snapshot of Kentuckians who can now obtain coverage include cashiers from the IGA, clerks from the dollar store, workers from the lock factory, call center agents, laid-off coal miners, KFC cooks, and Chinese green card holders. For the first time, these working Americans will have access to health care. Ironically, Kentucky is the home of Senate Minority Leader Mitch McConnell, who's been traveling around the state blasting the law. Now, thousands of McConnell's constituents have access to health care for the first time in their lives.

In 1966, Martin Luther King Jr. said, "Of all the forms of inequality, injustice in health care is the most shocking and inhumane." Social reformers from the turn of the 20th century until today including FDR, Florence Kelley, and Frances Perkins have called for a universal health care system for Americans so that we don't go broke if we get injured or sick. America, the richest country on the planet, is the only industrialized nation that has never provided universal health care to its citizens. When the Obama administration passed the ACA in 2010, our nation ushered in a new era in healthcare--one in which the most vulnerable Americans, those people tossed aside by insurers and hung out to dry by employers were given an affordable way to get care in the case of unforeseen illness or injury. Obamacare sent a message to struggling Americans that this country would no longer let 47 million people struggle without health care.

Unfortunately, the rollout of the law on October 1 was problematic, to say the least. Healthcare.gov wasn't ready for prime time. Better testing of the site prior to the launch day would have revealed many of the flaws. But an overhaul of our healthcare system is a massive undertaking, and we'd all do well to remember that the program is more than just a Web site. We should not throw the baby out with the bathwater.

In fact, since the 2010 passage of the ACA, we have already made great strides. Because of Obamacare, today young adults can be covered by their parents' health care plans until age 26. Before ACA's implementation, kids were tossed out of coverage at age 19--a stipulation especially cruel for those unable to find employment in this tough economic environment.

Obamacare has made it illegal for insurance companies to deny Americans coverage due to "pre-existing conditions." This substantive policy change not only opened doors for millions of Americans who previously had no access to coverage, but also changed public perception of how we should care for those already suffering with illness or injury.

Obamacare ends yearly and lifetime dollar limits on coverage of essential health benefits, and women will now be guaranteed preventative services including birth control, mammograms, and cervical cancer screenings. Many other preventive care services are mandated in the new law.

Yes, the rollout has been tumultuous, but we must not overlook the immense good Obamacare already offers us. We've also been here before. In 1965, the Medicare rollout faced an equally traumatic start. Many were confused about whether signing up would cause the loss of Social Security, doctors campaigned to boycott the program, and hospitals in the South refused to comply with the law because it banned racial discrimination. Predictions of doom filled the nation's papers, with eminent voices warning of coming disaster. But in the end--and it took some years--the nation's health care system weathered the crisis, with private insurers and government working out the kinks.

In 2005, Medicare Part D, the Medicare Prescription Drug Plan, launched a month behind schedule with a Web site that was missing key information and operating painfully slowly. Nearly 10 years later, many on both sides of the aisle consider Medicare Part D a success.

And the naysayers of today were singing a different tune only a few short years ago. In 1989, the Heritage Foundation proposed an individual mandate (same as in Obamacare) in a document titled "The Heritage" Plan, stating "all citizens should be guaranteed universal access to affordable healthcare." And in 2006, Mitt Romney, a Republican governor and future Presidential candidate, implemented the nation's most progressive sweeping healthcare reform law in Massachusetts, now known as Romneycare. There was a time when both parties recognized that our healthcare system was not sustainable.

Obamacare will not only provide health care for the 47 million previously uninsured Americans, but will help save billions of dollars. The Council of Economic Advisers reported this week that health care spending is the lowest on record since the act was passed in 2010, and found that the ACA has "substantially improved the long-term federal budget outlook."

Alan Blinder, former Vice Chair of the Federal Reserve, pointed out earlier this month in the Wall Street Journal that in spite of a tumultuous rollout, the "three central elements of Obamacare are insurance reform, getting (most of) the uninsured covered, and containing the upward spiral in medical-care costs. Each remains in place."

Since the ACA passed three years ago, the House of Representatives has voted to repeal or defund the law more than 45 times. House members clearly care little that millions of Americans have gone without healthcare for generations. We can't let the naysayers use the rollout snafus to undermine all the good Obamacare is bringing and will bring to our citizens. As with the Medicare program, we will need time, patience, and good will to make it work. It's well worth the effort.

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