Editorials

ACA alive and well in NC

Even if full repeal of the Affordable Care Act now seems off the table, actions by the Republican-led Congress and the Trump administration could undermine the ACA’s insurance markets.
Even if full repeal of the Affordable Care Act now seems off the table, actions by the Republican-led Congress and the Trump administration could undermine the ACA’s insurance markets. AP

Donald Trump and Republicans in Congress have done everything they can to kill the Affordable Care Act, the signature achievement of the Obama administration that has made it possible for more than 20 million Americans to get health insurance. That has most assuredly saved some from poverty, and it likely has been a literal lifesaver for others.

But Trump used the bellowing phrase of “repeal Obamacare” as a campaign staple, gathering lusty cheers from his right-wing base, some of whom likely were on “Obamacare” but didn’t realize it because the official name of the program was the Affordable Care Act. But Trump’s attacks represented the most virulent form of the politics of hate, and that hate for Obama helped him win the presidency – despite the fact, ironically, that both Obama and the ACA were more popular by the time the 44th president left office.

In North Carolina the ACA remains popular indeed. Despite Trump’s administration having shortened the signup period for 2018 – the mandate requiring signup or a penalty also has been nixed in the GOP budget – some 523,989 North Carolinians signed up for health insurance through the ACA. That’s the third highest enrollment in the country, behind Florida and Texas.

And those signups came through federal exchanges only, since the Republicans in charge of the General Assembly of course decided not to set up a more accessible state exchange to help people get the insurance. It’s thus all the more remarkable that North Carolinians continue to find a way to get insurance with the ACA, though there was a slight drop this year due to the shortened sign-up period.

North Carolina’s Republican leaders made other foolish, even cruel decisions with regard to the ACA as well, passing up millions and millions of federal dollars and thousands of jobs that would have come to the state if GOP leaders had opted, as they could have, to expand Medicaid under the ACA. They did not.

Gov. Roy Cooper rightly asked the federal government for an extension to the sign-up period. Not surprisingly, this being the Trump administration, that request was not granted.

“North Carolina’s strong signup numbers – despite a drastically shorter enrollment period – show that our families want and need quality health coverage,” Cooper said. “I am certain that we could have served even more families had the deadline been extended ... people with access to health insurance are able to stay healthier and seek and maintain employment, which is good for our state’s economy.”

Republicans have no sensible answers as to why they declined to expand Medicaid or to set up a state exchange. The non-sensible answer is: We hate Barack Obama and wanted to do anything not to cooperate with his administration, even if it meant half a million North Carolinians wouldn’t get health insurance coverage.

What Trump and his administration ought to see in the continued popularity of the ACA is a program that should not just survive but be strengthened. Alas, all they can see is an angry red when it comes to anything accomplished by Trump’s predecessor.

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