A man fills out an information card during an Affordable Care Act outreach event hosted by Planned Parenthood for the Latino community in Los Angeles, California, September 28, 2013. (Reuters/Jonathan Alcorn)
On Tuesday, as federal employees packed up their belongings and the webpages of several agencies went dark, millions of Americans attempted to log onto newly launched government sites to explore their insurance options under the Affordable Care Act. Many people encountered error messages or slow connections, not because Republicans succeeded in damaging the ACA’s rollout by shutting down the government but because public interest overwhelmed the sites.
Maryland resident Nancy Beigel spent Tuesday evening trying to enroll through her state’s Health Benefit Exchange. “I have been counting the days,” she told me, but said she wasn’t surprised that the sites were bogged down.
Beigel has been waiting for ten years for healthcare reform, since she became unable to work full-time in her mid-40s and lost her employee insurance. For a while she paid for her own coverage, but her premium rose consistently. When it amounted to a third of her income—not counting co-payments for care—she dropped her plan. “I had to make a really difficult decision: do I keep my house, a roof over my head, or do I keep [insurance]?” Beigel said. “I was running up credit card debt like crazy trying to pay for the premium, maxing out cards right and left, and I realized this cannot go on forever. So I gave up [insurance].”
Beigel could not go without care, however. She’s in her 50s now, but has been unwell since long before middle age, and her ailments require constant treatment: fibromyalgia, high blood pressure, blood clots and osteoarthritis. During an emergency appendectomy in 2009, her surgeon discovered a malignant tumor. Later, she recalled, her primary care doctor told her that no one would insure her after a cancer diagnosis. “He said, ‘You’re done.’”
Without insurance, she’s forgone screening recommended by her oncologist, curtailed routine testing she is supposed to receive for her chronic conditions and put off treating a leg problem that makes it difficult to work. Her credit is ruined. Talking about what the Affordable Care Act means to her, she began to cry. “I finally have a chance,” she said. “This is not an entitlement. This is a mercy.”
Nancy Beigel is why congressional Republicans have shut down the government; why millions of public servants are working or not working without pay; why vulnerable women, children and veterans are wondering how soon the benefits they rely on will run out. They’re afraid that if Beigel and millions like her are allowed to taste “the sugar” of health insurance—meaning, if they’re allowed to join the marketplace they’ve been locked out of—it will not only be impossible to repeal the ACA but also difficult to argue that any money spent by the federal government in the public interest is poison.
But by forcing a shutdown Republicans have squandered whatever political capital was left to squeeze out of the anti-Obamacare furor. Reports on the “glitches” in the online insurance marketplace have been drowned out by shutdown news. In fact, the amount of traffic on the websites offers an early indication that Americans are not so misinformed or confused about the law that they’ll fail to sign up. Conservative pundits like Jennifer Rubin, Robert Costa and Byron York are writing about the GOP’s internal struggle and how the party can extricate itself from the mess, rather than the horrors of healthcare reform.
If Republicans are truly concerned that the ACA will destroy the American way of life as we know it, they would have been better served to let the law fail, and reap the rewards in future elections. But they know that won’t happen. If the law succeeds it will gradually become clear that the GOP wasted three years building a platform around a single, unconscionable goal: denying access to care. Rather than end the American way of life, the ACA will end, or at least chip away at, the American way of making health insurance a luxury reserved for the privileged.
Now that the exchanges are open, the only thing that impacts the future of the ACA is whether they work, which depends on people like Nancy Beigel and young, healthy people signing up. Accordingly, the fight in Congress is no longer about derailing Obamacare. It’s about a small group of hard-right lawmakers in one chamber of one branch of government, empowered by gerrymandering and big-money elections, testing their ability to subvert the system of governance.
Is the Republican battle against the Affordable Care Act really anything like the struggle to end slavery?