Healthcare Stress

It’s what Republicans have dreamed of for ten years.

The Supreme Court, at long last, is poised to drive a stake through the heart of the Affordable Care Act. And at a perfect time, too. When better than during a global pandemic? Finally, the gleeful snatching away of health insurance from 20 million people is in their sights.

But it’s worse than that. If the Court votes the wrong way, Covid victims could end up uninsurable for the rest of their lives. It’s already clear that the Covid-based health issues of today are the pre-existing conditions of tomorrow. Without Obamacare, any condition deemed pre-existing might never be covered again.

Of course, when I say the Court, I mean John Roberts. With last week’s Louisiana abortion decision, Roberts made clear that he holds the only vote that counts. The decision was encouraging, but only barely. He held his nose and sided with the liberal wing, citing respect for established precedent. Of course, the Voting Rights Act had plenty of established precedent as well, so how seriously can we take that argument?

But he certainly pissed off a lot of evangelicals and others for whom abortion is the only issue that matters. And he could save Obamacare with a similar stunt, if he’s in the mood. He’s done it before, and there’s precedent there that he might choose to respect. Or not. The truth is we have no idea how he’ll vote. And we probably won’t find out until after the election. But that’s okay. Millions of families can easily stay terrified until then. They’re used to it.

But while the Court can make the healthcare situation immeasurably worse, it can’t make it better. As we watch the virus ravage the south and west in the next few weeks, we’ll start to see just how shaky the entire healthcare system is, especially in states that reopened too soon after closing too late.

The human loss, depressing enough, will be accompanied by a huge test of what’s left of Obamacare. Even if it survives its Court battle, Covid is putting it under more stress than was ever anticipated.

ACA was never anybody’s idea of a great healthcare plan. From the start, it was a cobbled-together, over-complicated approach, tailored to conform to what Democrats guessed Republicans might actually support.

They guessed wrong. Republicans rejected it anyway — even the parts that were their idea — mostly because the president at the time was Black. In their loathing, they labeled it “Obamacare,” a sneering pejorative that Obama turned around on them, taking ownership of it for himself. They’ve been trying to kill it ever since, but it’s still the law of the land. Now, with Covid putting the whole jerry-rigged system under pressure, any weaknesses in ACA will surely be exposed.

Many of those states that are in the crosshairs of the virus — all run by Republicans, not coincidentally — are states that, for no rational reason, turned down ACA’s Medicaid expansion. Never mind that it would have brought billions in federal money into their healthcare systems. Again, it was the Black guy’s idea, so they weren’t interested.

Wouldn’t that money come in handy right about now, what with the virus putting the squeeze on? Do they understand they’ll be paying for their idiocy, both medically and financially, for a generation? Do they care?

As it happens, there’s been some pushback about that. Last week, Oklahoma — a state as red as they come — put Medicaid expansion on the ballot. And won. The electorate basically gave the finger to all the corrupt Republicans they themselves had elected, and said they wanted Medicaid immediately, if not sooner.

But that’s a rare piece of good news. Because the stress on our entire healthcare infrastructure is likely to be severe. Whole hospital systems could go under. Cities and counties could go bankrupt, with ripple effects all through the private sector. Without federal help — which will surely be too little, too late — states and cities will see major layoffs of police, fire, sanitation, and government workers of every stripe. Maybe by fall.

We need to chalk all this up, once again, to Republican malfeasance, which has gone from larcenous to murderous. Their decades of callous disregard for the health of our citizenry — and for our government’s duty to underwrite it — is now costing real lives in real time. They don’t care. Human life does not factor into their thinking.

But even for those stuck in the Trump/Fox alternative reality bubble, you’d think it would sink in that this virus is not messing around. That it thrives on their nonchalance. That masks are about safety, not politics. That Trump rallies are disease vectors. That Republicans do not have their back.

And that the Court they’re counting on to kill abortion, might just kill their health coverage, too. Or instead.

Berkley MI

Friday 06/03/20