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Anyone following my 140 character rants on Twitter should know that I oppose the Affordable Care Act because it is not liberal enough. If the for-profit health insurance industry was going to be allowed to continue to exist, it should be kept on a short leash. In this aspect, the ACA is somewhat successful. No longer can those with pre-existing conditions be turned away, children may stay on their parent’s health insurance plans for much longer and a much larger percentage of monthly premiums paid must be used on healthcare rather than administrative expenses. All of these are good things, but not nearly enough in a nation which has not only some of the finest healthcare in the world, but some of the most unaffordable. The lion’s share of the blame for that lands on the for-profit health insurance industry.

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I actually have a lot I want to write about, but at the moment I've got "Obamacare" (the law actually called the Affordable Care Act) on the brain. And it seems I'm far from the only American in that position.

I am fine with paying taxes for healthcare - in fact, I would much prefer a single-payer system (Medicare for All). What I take exception to is being forced into lining the pockets of CEOs in the health insurance industry by a government which is supposed to be representing me. My tax dollars are already spent when I get my paycheque, but to be told after the fact that I have to use what used to be a portion of my already meager disposable income in order to purchase a defective product (and health insurance remains as such no matter how many regulations are placed on it so long as it is controlled by the profit motives of the private sector) is galling.

When I lost my job of seven years back in 2011, I got six months of health insurance as part of my severance package. After that I went without because there was no way I could absorb the hit of a $600/month COBRA payment. I am employed again, but still going without because the health insurance plan offered is horrible: it would eat up nearly 25% of my (reduced) income, not cover my daughters nor their mother and comes with hefty co-pays and fees just for taking "advantage" of the "coverage."

Since going live this week, I've been trying to give Obamacare (really, national Romneycare, but let's not stop Democrats and self-professed liberals from cheering on this republican idea passed by a "Democratic" president and House) a chance. Visits to healthcare.gov have met with error messages on the rare instances that I've not been stopped at the landing page which unhelpfully informs me that I need to stay there because I'm in some invisible queue.

With the definitive ACA site not giving me any answers, I've tried to glean what to expect in trying to square myself with this law. I don't want to end up fined and still be sans health coverage (especially since it is not clear whether or not those fines will be a flat fee or multiplied by the number of months one has neglected to pay the insurance man). The Kaiser Family Foundation's Subsidy Calculator estimates coverage for my family will cost $80 per month based on total household income (I work 40 hours per week, my partner 16). Not great, but could be worse, I suppose. Where it does get worse is if my partner decided to start working full time. In addition to the expense of putting our children in daycare when we are both at work, our household premium (according to KFF) would jump to $300/month. We make the same amount of hourly income. How is it that a 43% increase in income causes a 375% increase in one's insurance premium?

Maybe the offerings once I get into healthcare.gov will be better. I certainly hope they are. However, I remain extremely skeptical about the whole messy affair.

As for the teabaggers who have taken over the republican party and shut down the government in a childish attempt to kill a law they don't like: fuck 'em. You don't mix issues and destroy the economy and people's lives over petty ideology...unless you have a seething hatred for Democracy.

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Over the next three days The Supreme Court is deliberating on the Constitutionality of the Affordable Care Act. The main theme being driven home by news outlets was the mass of activists which had congealed outside of the Supreme Court building. Religious groups are protesting the law under the claim that it infringes on their freedom of religion to infringe on people's freedom of self-determination. Meanwhile so-called "liberals" are out en masse to show their support for the law.

All of these people need a good, hard smack upside the head.

I can't speak for the Constitutionality of the law overall; the portions regulating the health insurance industry are well within the limits of the framing document. However, the provision of the law requiring everyone to purchase health insurance - the "individual mandate" - is the sticky portion which oversteps the bounds of what should be required of a law. Using flawed reasoning similar right-wingers' defense of requiring photo identification at the polls, proponents of the individual mandate say that anyone driving a car is required to purchase auto insurance so why should it be that someone alive shouldn't be required to purchase health insurance? Simple: just as voting is a fundamental right which one should be able to exercise with undue burden, no one chooses to be born. People can opt not to purchase a motor vehicle - driving a privilege, not a right. However, there is not one human being on the face of the planet who chose to be conceived - and once alive people have few options outside of remaining so until their natural expiration date (suicide, while an option, is still technically illegal).

Nowhere in the first ten amendments to the Constitution does it state that people have the right to be fiscally enslaved by the health insurance industry. Nor does such a statement exist in any of the subsequent amendments (though if 2/3rds of the states voted "yay" to such a thing it could come to be). The Obama administration, in bringing Romneycare to a national level has presented us with that stark reality come 2014 when the "individual mandate" kicks in. If you don't have insurance via your employer or you've neglected to purchase it individually, then you will be breaking the law. As it stands now, the only penalty for doing so is to have your tax refund confiscated, however I'm certain congress will find other ways to punish those who do not render unto the health insurance industry.

That is the main problem with the Affordable Care Act: in spite of all the needed regulation it applies to the health insurance industry, at it's core it is a huge giveaway to that industry. Millions of Americans will get coverage at the expense of losing their ability to be free of the shackles of yet another corporation. If there is one lesson which Americans never seem to learn it is that corporations do not exist for the public good; they exist only to increase profit margins. When it comes to benefiting the public, a corporation will always fail.

The Affordable Care Act, now so reviled by Republicans and so-called "conservatives" is actually the free-market compromise to socialized health care. This was the main reason that Mitt Romney, as governor of Massachusetts was willing to sign off on it at the state level: what came to be sneered at as Obamacare in it's infancy as Romneycare was an obvious boon to the big business of health insurance. What Republican wouldn't salivate at the opportunity to enrich an already bloated industry under the guise of helping Joe Lunchbox? For getting passed on a national level what Mitt Romney merely managed on a state level, Barack Obama ought to be considered the greatest Republican President to ever occupy the White House. Since he is registered as a Democrat, however, the Republican Party is in full tribal warfare mode.

It all comes down to the fact that healthcare reform was a massively missed opportunity. If Obama were the socialist his detractors accuse him of being - and I really wish he were - then he would have used his bully pulpit to push for Medicare for All (HR676; also known by the technical name "single payer"). As it stands, it took a "democrat" to pass Republican legislation on a national level. Any real hope of saving millions of dollars, cutting out masses of bureaucracy and making sure that every single American's health care is paid for without worry has been thrown out of the window.

And now the Affordable Care Act is being judged before the Supreme Court, an institution whose greatest hits include appointing George W. Bush as President and giving corporations the right to spend indefinite amounts of money politicking. I can see no good coming from whatever decision the Supreme Court reaches: either the entire law will be thrown out, lifting the good portions which actually regulate an industry which would just as soon have those who can't pay dead or the entire law will be kept, leaving the American people to be fiscal slaves - legally to boot - in service to yet another corporation.

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Seth Warren

May 2017

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