Gov. Chris Sununu has responded to inquiries from Congress about the state’s position on the repeal of Obamacare in a Jan. 18 letter that recently surfaced. The congressional inquiry requested feedback from the nation’s governors and insurance commissioners about the proposed repeal of Obamacare. While the governor declined to respond to any of the nine questions posed by Congress, his response exposes his troubling and uninformed views about health care in the Granite State.
The Affordable Care Act, known as Obamacare, was passed without significant participation from Republicans in Congress. The Republicans’ stance was purely political, part of the “Just say no” approach to anything President Obama proposed.
Obamacare was pilloried by the Republicans. So much so and so effectively that on the campaign trail in 2010, I heard voters tell me they vigorously opposed the “government takeover” of their health insurance but “you keep the government’s hands off my damn Medicare,” despite the fact that Medicare is a federal government single-payer, government-administered health insurance program for older Americans and Obamacare was a proposal in which private insurance companies and not the government would provide and administer health insurance through a marketplace called the “exchange.” Such is the power of alternative facts and effective political messaging.
Since Obamacare’s passage, more Americans have health insurance. The steep rise in the cost of health care has slowed. For the first time in history, the health insurance industry, which was rife with discrimination and administrative bloat, serves people and not just profit. Administrative costs are controlled. The government provides subsidies to help Americans buy health insurance from private insurance plans. Importantly, but not widely known, Obamacare spelled out a revolution in the way health care under Medicare would be paid for, moving from reimbursement for “quantity” of service to “quality.”
Medicaid, in most states, has been expanded through federal government subsidy, providing health insurance to more lower-income Americans and dramatically reducing uncompensated hospital emergency room visits, a significant driver of health care cost. Here in New Hampshire, after much debate, the state forged a New Hampshire solution on Medicaid expansion in a bipartisan compromise.
Gov. Sununu, however, seems to have whole-heartedly bought into the rhetoric and not the reality of health care in the Granite State. He relies on alternative facts to declare in a Jan. 18 letter that Obamacare has been “disastrous” with “rising costs.” In fact, the rate of increase of health care costs has declined and while premiums for some have risen as insurers adjust to the market, government subsidies have reduced the overall cost for many. He asks for the flexibility to design a New Hampshire-based system, ignoring the fact that the New Hampshire Legislature did just that, in a bipartisan, New Hampshire-specific compromise for Medicaid expansion under which, for example, 107,000 Granite Staters have access to mental health and substance abuse treatment.
There is no doubt that Obamacare could be improved if the political climate were different. When the bill was being written, I advocated a “public option,” a single-payer “Medicare for all approach” to health care to provide basic health care with an appropriately regulated private insurance market competing for business. But, the governor longs for the “creation of narrowly focused market-based solutions rather than onerous regulations.” This language is code, and it is troubling code.
Apparently our governor wants to return us to the mythical “good old days” – those halcyon days of yore when health insurance companies were free, without government interference, to raise our rates through the roof, deny insurance to those with pre-existing conditions, discriminate against women, knock kids off their parents’ policies and deny insurance to those who exceeded arbitrary lifetime caps.
An unregulated, for-profit health care industry is, by its very nature, more concerned with profit than people. Affordable high-quality health care should be a right, not a privilege for the elite who can pay.
Gov. Sununu, a scion of privilege, may never have faced the challenge of access to health care. He may not understand the struggles of working Granite Staters who rely on Obamacare and Medicaid for their health insurance. He may be uninformed about health care in New Hampshire. But, his call to return to a “free market” in which insurers are free to care only about their profit with few rules to protect the people of New Hampshire and the nation is the tone-deaf cry of a corporate elitist.
Governor, please read up on the facts and drop the rhetoric. New Hampshire deserves a more informed, caring, complete and thoughtful response about our health care.
(Paul Hodes of Concord is a former U.S. representative for the Second Congressional District.)