It has been a rough few months for me culminating in today, inauguration day. And I know there are plenty of folks out there that say that it is just sour grapes for me. That the guy who freely talked about grabbing women’s parts won the election fair and square so I should shut up and try to unite this country. Maybe that is the case but it is so much more than that for me. And a lot of it has to do with the Affordable Care Act otherwise, known as the ACA or Obamacare.
Implementation of the ACA has been the focus of my job for seven years now. I have lived through seven years of reading through rules in the federal register. Through assessing sub-regulatory guidance on things like preventive services. Through participating in a ridiculous number of phone calls at all times of the day since the federal government does not give a hoot about my time difference issues. I have created enough overviews on the ACA for my organization that if I printed them out I could wallpaper my entire apartment and then some. I have had countless meetings starting with trying to get the state’s exchange, the Hawaii Health Connector, up and running. My throat goes dry just thinking about all the presentations that I have given on the good, bad and ugly of the ACA. I have lived and breathed and supported much of its intent over these seven years. It is not easy for me to see it go away.
So, I feel like I am in mourning. Mourning for a really large and complicated piece of legislation. One which, aggravated me, irritated me and caused me endless grief. But one which, I could not help but admire in its pluckiness and its continuing attempt to make things better. Not for insurers. But for consumers. No, it is not perfect, but given its scope, nothing that large and comprehensive ever could be. It made so many changes for the better, especially for individuals, to obtain health care coverage. It has decreased the uninsured rates by leaps by making individual coverage accessible and expanding Medicaid. It has slowed the number of Americans filing for bankruptcy due to medical costs. Again, it was never perfect. And it was too bad the partisan politics prevented any changes from being made which could have actually improved it.
And maybe, to me, the saddest thing of all, is that now, now that people may actually lose the coverage that they have gained through the ACA, it actually has a favorable approval rating. The Obama Administration never had a great handle on the messaging around the ACA and when exchange platforms faced problems and a great cry arose that it was not possible to “keep what you have”, there was never a great response. Never a response that resonated. And the media war was lost. Until now, now that it looks like the ACA may actually be repealed in some fashion. I will never understand it nor will I pretend to. Why the ACA did not have the support. Why, as a nation, can’t we be worried about health care coverage for our neighbors, loved ones and the guy in the store you don’t even know. Even the guy sleeping on the street. I can only hope that the rallying cry to Make America Great Again will mean something to me someday. Today, it makes me look back to a time when most individuals could not pass a pre-existing condition screening and could not obtain health coverage at any cost. And if they did, there was no way for them to have drug coverage. No way. Literally.
I will try to remain optimistic but the Executive Order issued today does not provide me with much hope. It seems that hope has left Washington, DC today and it feels like it may never come back. I will try to keep it in my heart. But at this time, it is a barely glowing cinder which may extinguish at any moment. I am in mourning, yes. For the ACA, for the country’s health policies and maybe for myself a little bit. Pity party? Maybe. But I feel like I deserve it. If not just for today.