The Historic Opportunity Before Us: We Must Act Now
It’s time for Congress to move us towards a healthier future
The year between 2009 and 2010 was both incredibly memorable and a total blur for me. I was counsel to then-Senator Jeff Bingaman and deep in Affordable Care Act negotiations. Working day and night, I drafted language, managed roundtable briefings, negotiated terms, revised language, re-wrote provisions, and worked doggedly to sell the ACA on behalf of my boss. This bill was personal to me because I knew it could help the people in my community; people like a man who lived in a park in my neighborhood. I first spotted him while taking my dog, Winston, on our daily walk before diving into whatever that day was going to bring. He was probably about my age, slept in a small tent or sometimes just a sleeping bag, and clearly had untreated mental health conditions. As spring turned into summer, fall, and eventually winter, I watched his condition deteriorate before my eyes. He went from looking 30-something to 40-something until he looked ancient, and my heart just broke for him. He was my motivation to keep fighting for the ACA.
This neighbor was on my mind every day, right up until March 23, 2010. Not a date that means anything to most people. But this was the day I knew the years of work we devoted to this bill were worth it because it was the day I watched the president sign it into law.
There had been so many times that I didn’t think I’d ever see that moment. But I was thrilled to stand side-by-side with my colleagues in Congress who had also poured their hearts and souls into making that moment possible. But even then, I would have told you it was another milestone — not the finish line — in the marathon race to ensure everyone in America has the opportunity to live healthy, fulfilled lives.
We are still several miles away from being able to run through the tape, but Congress has another truly historic opportunity to move us closer to that goal. And the importance is even more acute now, as we struggle to end a global pandemic that has devastated millions of families across the country, from New York City to Jackson, Mississippi to Anchorage, Alaska. And, in particular, the crisis has ravaged communities of color, spotlighting longstanding inequities with deadly consequences. These communities are trapped in an ecosystem of challenges that put them at a disproportionately higher risk of negative health outcomes — from diseases to early death. These obstacles include where they live, the frontline jobs they hold, and a lack of access to health care services, which are bound together by a history of systemic racism that continues to contaminate our society as a whole. Passing the Build Back Better Act would give us a very real opportunity to improve millions of lives and ensure that our nation is a place that fosters the best health possible for all.
It’s also a chance for Congress to respond to demands from people across the country who have made it clear that they want these policies. As my team at Families USA outlined in a recent report — appropriately named What’s at Stake — voters know that this could quite literally be life or death for them. Health care affordability is one of the most important issues for families across the nation, no matter party affiliation, geography, race, or ethnicity. In fact, nearly 90 percent of people across party lines say they want Congress to act now to lower drug costs. Almost 80 percent of Americans support closing the coverage gap so that the 2.2 million people in 12 states that haven’t expanded Medicaid can afford and get care.
But this isn’t just about doing what’s popular. There are smart policy reasons to make sure three key areas are covered in the bill:
Authorizing Medicare to negotiate drug prices isn’t controversial or complicated — it’s one of the most basic business principles to make sure you can get the lowest price for anything you buy. As anyone who’s ever worked for a federal agency can tell you, the government already negotiates prices with vendors for everything — from staplers to defense missiles. In the most basic terms, the U.S. government tries harder to save money on paper clips than Epi-Pens. Even though Medicare is one of the pharmaceutical industry’s biggest and most loyal customers, Big Pharma arbitrarily sets the prices — and the American people are forced to pay it. Not only is this predatory, but it’s also just inexplicably bad business. Build Back Better would help the country save an incredible $80 billion every year by finally authorizing Medicare to negotiate drug prices, stop annual price increases that rise faster than our pay checks, and curb other drug company abuses. More importantly, it would ensure people don’t have to choose between paying the rent and purchasing their life-saving medication.
- Closing the Medicaid Gap
There are holes in our social safety net, and they’re getting bigger. When asked, most people in our nation believe if a family is struggling and living near or below the poverty level, they can get health care through the Medicaid program. Sadly, this is not true in the states that have refused to extend Medicaid to their most vulnerable families. All told, there are 2.2 million people in 12 states in this coverage gap — 60 percent of whom are people of color. These consumers are more vulnerable to falling sick and too often they don’t have the money to pay hospital bills, driving them deeper into poverty. On the other hand, people who live in the vast majority of states that did expand Medicaid live longer and are less likely to struggle to pay the bills. Build Back Better also invests heavily in new moms and children by protecting perinatal coverage in Medicaid and providing children with annual Medicaid coverage, ensuring paperwork doesn’t stop kids from getting health care. These improvements would be among the most significant investments to support health equity, accessibility, and overall health for everyone.
- Lowering the Cost of Plans on the ACA Marketplace
While more than 14 million people currently get health coverage through the Affordable Care Act marketplaces, many people still struggle to afford high premiums. Build Back Better is an opportunity to extend the premium subsidies that were a part of the American Rescue Plan that Congress passed earlier this year, making it significantly easier for people across the country to afford coverage. People want health care and it’s absolutely possible to get working and middle-class families covered with the right approach. Consider this: 1.1 million people signed up in Florida and Texas alone once the ARP subsidy was implemented.
There’s more that still needs to be done — that’s why this is just another leg in the marathon. Notably, the exclusion of dental care for seniors and people with disabilities on Medicare from Build Back Better is incredibly disappointing. But it’s popular, smart policy and our work in the last years has only renewed the passion of advocates and everyone who’s impacted to get it done.
I still think about the man in the park and he still motivates me to continue pushing until we finally achieve affordable health care for all. Most Americans agree he should have access to health care. In a nation that is already spending so much more than others on health, why in the world should he be left behind? Now that the House of Representatives did their job by passing Build Back Better, it’s time for the Senate to seize the opportunity in front of them and help my neighbor and the millions of others struggling to get by.
