by Danny Haiphong
Barack Obama is busy packaging his “legacy” as the First Black President – which is a fact – and as a “progressive” – which is patently false. His supporters tout the Affordable Care Act (ACA) as his crowning achievement. However, “from its very roots, the ACA was destined to consolidate the corporate insurance and pharmaceutical industry's control over US healthcare.”
The Obama Legacy Part 1: Profits for the Monopolies, Healthcare for Those Who Can Afford it
by Danny Haiphong
“The US leads the world in healthcare expenditures and healthcare-induced debt.”
As the Sanders campaign grinds to a halt, it is critical to examine what conditions brought about the crisis of legitimacy that currently afflicts the US political apparatus. The Obama Administration bares much of the blame. In this multi-part series, the most critical crimes of the Obama Administration will be explored. President Obama's two-term reign is rapidly making its way toward the history books. Yet the impact of Obama's policies will endure for years to come.
Healthcare has been a point of discussion in the 2016 elections. Millions of people in the US are angry about the healthcare system, and for good reason. For the last eight years, the narrative around healthcare in Washington has been confined to the terms and conditions of the Affordable Care Act (ACA). The debate has centered on the attacks ACA has received from the Republican Party. ACA is thus a critical piece to the puzzle that is the Obama legacy.
What isn't discussed often enough is how Obama has worked tirelessly to protect and fulfill the interests of the corporate healthcare system. In 2009, he collaborated with the monopoly health insurance industry and its pharmaceutical counterparts to repress the demand for single payer healthcare. The conditions at the time appeared ripe for a single payer system. Popular discontent with Republican Party rule was at its highest point. A relatively organized movement for single payer care was represented by organizations such as Healthcare Now. The Democratic Party possessed a majority in both the House and Senate.
“Obama has worked tirelessly to protect and fulfill the interests of the corporate healthcare system.”
Despite these favorable conditions, Obama proceeded to broker with the corporate healthcare monopoly. The result was a piece of legislation created by the corporate healthcare system itself. The Affordable Care Act was modeled after the Heritage Foundation's model for healthcare reform, first instituted in Massachusetts. One of its key architects, Liz Fowler, wrote the bill as a former VP of WellPoint (now Anthem) before taking a lucrative position with pharmaceutical giant Johnson-Johnson in 2012. From its very roots, the ACA was destined to consolidate the corporate insurance and pharmaceutical industry's control over US healthcare.
Under the law, US citizens are mandated to possess health insurance prior to filing income taxes for a given year. Those who do not have health insurance are forced to pay a hefty fine. Working and unemployed people without employer-sponsored healthcare must choose from a system of government-subsidized corporate health insurance plans. The plans created by ACA vary greatly in coverage. Plans operate on a tiered basis. Platinum plans cover 90 percent of covered services but are the most expensive. Bronze plans are the least expensive, but cover just 60 percent of services rendered.
Supporters of ACA have attempted to ease the fear of inadequate healthcare coverage under the bill by talking up the Medicaid expansion option as well as the government issued subsidy. But Medicaid expansion has been left to the authority of the states, with 22 states opting out. Government subsidies only cover the Silver plans that have a higher deductable and pay for just 70 percent of covered costs. This leaves the majority of Americans earning less than 30,000 per year to choose the Bronze plan. For millions, neither Medicaid nor the Platinum plan will be an option for coverage. The vast majority of insurance recipients under ACA will thus pay for a large portion of their healthcare costs.
“Government subsidies only cover the Silver plans that have a higher deductable and pay for just 70 percent of covered costs.”
ACA has also placed the existence of employer-sponsored plans under great risk. A 2013 report from UNITE HERE details how the profitability of the exchanges far outweighs the punishment for not providing healthcare to workers. Employers are given the option of paying up to $10,000 per worker for health insurance coverage or suffer a $2,000 fine for every worker that goes uninsured. Furthermore, there is nothing in ACA that prevents employers from cutting hours in order to avoid healthcare costs. According to the study, hundreds of UNITE HERE employers cut benefits as soon as the employer mandate went into effect in 2013.
Instead of moving to a policy of universal healthcare, the Obama Administration further privatized an already deeply corporate system through the passage of ACA. Millions of Americans will remain uninsured into the year 2019. Millions more continue to struggle to pay the healthcare costs leveled on them by privately owned, publicly distributed health plans. The US leads the world in healthcare expenditures and healthcare-induced debt. The cost of healthcare per person averages to about $9,086, while a quarter of people in the US report suffering from healthcare-related financial woes.
The only winners from ACA have been the "healthcare" monopolies. More people than ever are now covered under expensive ACA plans, leading to a predictable surge in profits. Many deem ACA the greatest achievement of the Obama Administration. From the vantage point of the health insurance industry, such a claim makes sense. For working and unemployed people, ACA has only guaranteed that more of the burden of healthcare costs falls on them. The struggle for universal coverage has been set back by ACA's passage. Healthcare remains a privilege for those who can afford it. Through all the spin regarding healthcare reform, it is this fact that has made Obama’s masters in the healthcare industry proud.
Danny Haiphong is an Asian activist and political analyst in the Boston area. He can be reached at [email protected]