The Affordable Care Act is on track

August 6, 2013 

Republicans have done all they can to stop it. In the GOP-controlled U.S. House, there have been 40 votes to repeal it. Crossroads GPS, run by Republican strategist Karl Rove, has circulated a video comparing it to a natural disaster. Republicans in North Carolina have refused its provisions providing for an expansion of Medicaid and turned down a $27 million federal grant to set up a state-run insurance exchange. But the obstruction on the right can’t stop what’s right. Obamacare is coming.

Obama administration officials announced Monday that the Affordable Care Act has arrived at the keyboards of Americans who lack health insurance or need a plan they can better afford. Consumers can now go online to and create personal accounts by establishing a username and a password. The password should be unique, but we suspect many will choose a variation of “Thank God,” “thank goodness” or “no thanks to the GOP.”

Constant opposition

Rarely has a federal program been so needed and so undermined by sweeping attempts to cut off its funding and petty moves to distort or hide its features. For instance, when administration officials tried to recruit the NFL to help with a public service announcement on details of the ACA and how to enroll, top Senate Republicans Mitch McConnell and John Cornyn warned the league that it might be hazardous to its product if it cooperated.

In a letter, the senators wrote, “Given the divisiveness and persistent unpopularity of this bill, it is difficult to understand why an organization like yours would risk damaging its inclusive and apolitical brand by lending its name to its promotion.” The NFL and other pro leagues have heeded the warning.

The senators’ language betrayed their wishful thinking. The affordable Care Act is not “a bill.” It is the law, passed by Congress, signed by the president who will be remembered (and, we believe, revered) for pushing it through and upheld by the Supreme Court.

On Monday, Health and Human Services Secretary Kathleen Sebelius announced the start of online sign-ups for personal accounts. And she pointedly noted that obstructionists will not stop the launch of open enrollment in insurance plans Oct. 1 with benefits becoming effective at the start of 2014. “Let me be clear,” she said. “We are on target and ready to flip the switch on Oct. 1.”

Pressing ahead

Sebelius and others are to be commended for their perseverance in the face of the obstruction of a law that will free millions of uninsured Americans from a dread of getting sick and deflate the ballooning costs of health care for those who are insured.

Yet the foot-dragging is not without effect. In North Carolina, for instance, it will be harder for people to find out about their eligibility and coverage because the state has declined to set up an exchange. The task of establishing the online marketplace and informing North Carolinians about coverage has been left to the federal government.

The federal government is reviewing the insurance plans – 67 plans offered by three providers – and is trying to inform the public through community groups. A recent study from the Society of Actuaries estimates 888,000 North Carolinians will buy insurance through the exchange.

Meanwhile, the lack of support for the ACA from North Carolina’s state government may have made some insurers hesitate about participating here. The lack of competition – along with a provision under state law that keeps the proposed rates secret until Oct. 1 – means rates will be higher than they would have been in a robust and open marketplace.

Popularity will grow

The negative effects of obstruction likely will be temporary. The ACA is gaining popularity by helping those with pre-existing conditions find insurance, and the law’s cap on administration costs has slowed the rise in health care costs. Like Social Security and Medicare, both opposed at their inception by Republicans, the Affordable Care Act will become a popular and essential part of a just and healthy nation.

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