History of Health Care in America, ACVDN Looks Back

How the roots of the Affordable Care Act were sown over a hundred years ago.     Why Did it take so long,  who blocked the way?

 Former President Theodore Roosevelt champions national health insurance as he unsuccessfully tries to ride his progressive Bull Moose Party back to the White House.     1912

President Franklin D. Roosevelt favors creating national health insurance amid the Great Depression but decides to push for Social Security first.    1935

President Harry Truman calls on Congress to create a national insurance program for those who pay voluntary fees.   The American Medical Association denounces the idea as "socialized medicine" and it goes nowhere.     1945

John F. Kennedy makes health care a major campaign issue but as president can't get a plan for the elderly through Congress.     1960

President Lyndon B. Johnson's legendary arm-twisting and a Congress dominated by his fellow Democrats lead to creation of two landmark government health programs:   Medicare for the elderly and Medicaid for the poor.     1965

President Richard Nixon wants to require employers to cover their workers and create federal subsidies to help everyone else buy private insurance.    The Watergate scandal intervenes.     1974

President Jimmy Carter pushes a mandatory national health plan, but economic recession helps push it aside.    1976

President Ronald Reagan signs COBRA, a requirement that employers let former workers stay on the company health plan for 18 months after leaving a job, with workers bearing the cost.    1986

Congress expands Medicare by adding a prescription drug benefit and catastrophic care coverage.    It doesn't last long.    Barraged by protests from older Americans upset about paying a tax to finance the additional coverage, Congress repeals the law the next year.      1988

President Bill Clinton puts first lady Hillary Rodham Clinton in charge of developing what becomes a 1,300-page plan for universal coverage.    It requires businesses to cover their workers and mandates that everyone have health insurance.   The plan meets Republican opposition, divides Democrats and comes under a fire-storm of lobbying from businesses and the health care industry.    It dies in the Senate.     1993

Clinton signs bipartisan legislation creating a state-federal program to provide coverage for millions of children in families of modest means whose incomes are too high to qualify for Medicaid.    1997

President George W. Bush persuades Congress to add prescription drug coverage to Medicare in a major expansion of the program for older people.      2003

Hillary Rodham Clinton promotes a sweeping health care plan in her bid for the Democratic presidential nomination.    She loses to Obama, who has a less comprehensive plan.     2008

President Barack Obama and the Democratic-controlled Congress spend an intense year ironing out legislation to require most companies to cover their workers;   mandate that everyone have coverage or pay a fine;   require insurance companies to accept all comers, regardless of any pre-existing conditions;   and assist people who can't afford insurance.      2009

With no Republican support, Congress passes the measure, designed to extend health care coverage to more than 30 million uninsured people. Republican opponents scorned the law as "Obamacare."     2010

On a campaign tour in the Midwest, Obama himself embraces the term "Obamacare" and says the law shows "I do care."         2012

Now if we can just keep the republicans from destroying it.

America Really Needs Obamacare, The Affordable Care Act

In a lot of big urban areas where a large share of residents lack health insurance, help isn't on the way.

Seven of the 11 large metro areas where the uninsured rate was higher than the 14.5 percent national average last year are located in states that refused to expand Medicaid under the Affordable Care Act.   Two are in Florida, three are in Texas, and the others are Atlanta and Charlotte, North Carolina.  The metro area with the highest uninsured rate was Miami, at a staggering 25 percent, compared to the national low of 4 percent in greater Boston.

Here's a breakdown of the biggest metropolitan areas' uninsured rates before the Obamacare coverage expansion began, courtesy of figures released by the U.S. Census Bureau.

ACV Blog

The Affordable Care Act called for Medicaid benefits to be available to anyone earning up to 133 percent of the federal poverty level, which is about $11,500 for a single person this year.   Twenty-six percent of people with incomes in this range were uninsured last year, the Census reported.

To date, 23 states, mostly Southern, haven't adopted the expansion, despite generous federal funding. When the Supreme Court upheld the Affordable Care Act in 2012, justices also ruled the Medicaid expansion was optional for states.

What makes matters worse for the people left out of the Medicaid expansion is that another part of the Obamacare law permits only people who earn at least poverty wages to get financial help paying for private health insurance -- so those who earn less get nothing.

According to the Henry J. Kaiser Family Foundation, those decisions not to expand the program will leave 4.8 million people uninsured. More than 1 million of them live in Texas, 764,000 are in Florida, 409,000 are Georgia residents and 319,000 live in North Carolina.

Four other large metro areas that the Census Bureau reported had higher-than-average uninsured rates are in states that expanded Medicaid this year: Los Angeles, San Diego and Riverside, California, and Phoenix, Arizona.

In a survey published in July, the Commonwealth Fund found that the states that expanded Medicaid saw a combined drop in the uninsured rate for people with incomes below poverty from 28 percent to 17 percent after the first round of Obamacare enrollment. In the states that didn't, the share without health coverage was 36 percent -- barely changed from before.

A Gallup-Healthways survey from August also revealed wide variation between Obamacare's effect on the uninsured rate between states that cooperated with the law's implementation, such as by expanding Medicaid, and those that didn't.

ACVDN

Amherst Democratic News