If I were a Democrat running for Congress in 2014 who supported the Affordable Care Act, known as “Obamacare,” I would be running a campaign explaining why I am proud of my vote. And I would challenge my GOP opponent to answer five questions:
First, without Obamacare, what would you do about people who lose their health insurance because they have lost their jobs and can’t get health insurance because they have a pre-existing condition?
Second, without Obamacare, what would you do about people who lose their health insurance because they have suffered a catastrophic illness and their insurance company refuses to renew them?
Third, without Obamacare, what would you do about so-called free riders? These are individuals who have never purchased health insurance yet still benefit because, under federal law, they are guaranteed access to emergency rooms. This means that they get to ride freely on the backs of their friends and neighbors who have paid insurance premiums over the years and don’t need to rely on emergency rooms yet subsidize emergency rooms in most hospitals with their tax dollars.
The answer to this obviously unfair “free riding” phenomenon is the individual mandate, which requires everyone to “pay or play” with a fine so that all contribute to the costs of healthcare since, at some point in their lives, all will need it.
The fourth question could be the real crusher in the 2014 congressional elections: If you support repeal of Obamacare because the individual mandate — “pay or play” — violates your conservative libertarian principles, does that mean you support repealing Social Security and Medicare?
This is not far-fetched. Indeed, the analogy is on point.
Recall that the Supreme Court, led by the conservative Chief Justice John Roberts, approved the constitutionality of the individual mandate by calling it a tax — i.e., it is within the power of Congress under the Constitution to fund and achieve its social and legislative goals.
Recall also that when Social Security passed in the mid-1930s, and Medicare in the mid-1960s, Republican conservatives also opposed it, using similar language protesting the affront to individual liberty and making similar ominous warnings about the approach, if not the arrival, of socialism in America.
Opponents of Social Security also argued, as they do today with Obamacare’s individual mandate, that young healthy people should not be forced to pay a tax if they don’t obtain health insurance to subsidize the old and infirm. But supporters of Obamacare point out that unless the young and the healthy are in large proportions participating and paying premiums, the cost of insurance, with a disproportionate base of the unhealthy and the infirm left behind, would be prohibitive.
The fifth question goes to a moral issue that I believe will resonate with the American people: Do you agree with conservative healthcare writer Avik Roy, that “no wealthy nation [such as America] should allow a destitute woman who has been hit by a car to die in the street”?