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The GOP: Still “Letting Them Die”

Republicans are still targeting the Affordable Care Act, but their answer to the problems health care reform is already solving for many Americans hasn’t changed much from that infamous audience response at the September 2011 GOP presidential debate.


  • Sen. Jim Inhofe (R. Okla.), in a recent interview, said that he “probably wouldn’t’ be here” if he’d been insured under the Affordable Care Act (ACA) when he had quadruple bypass surgery. Inhofe claimed there “would have been about a six-month wait,” because he didn’t have a heart attack. That’s not true. There’s no rationing of health care in the ACA. The law explicitly prohibits restrictions on care.
  • Sarah Palin served up her usual word salad in a column. Palin claimed that ACA’s online glitches are a feature, not a bug. They’re part of a conspiracy to make the ACA so “unworkable” that, “People will be frustrated, worn out, and broke under this new government burden,” that they’ll end up demanding “socialized medicine.”  The plan, Palin says, is to “break our health care system (where, presently, no one is turned away from emergency rooms and we have many public and private safety nets for people in need), along with busting our personal bank accounts.” Then, “The cry will go out, ‘Can’t you just put us all in a sort of Medicaid-like system? It’ll be much less confusing than these awful exchange websites and a lot less expensive!’”
  • Sen. Ted Cruz (R, Tex.) joked, during a speech in Houston, that the ACA website was being run by “Nigerian email scammers,” who have been so scarce lately because, “They all have been hired to run the Obamacare website.”

As Matt Yglesias writes, the problem for conservatives is that the ACA is more than a website. Americans may bypass the website and apply for coverage under the ACA by phone, in person, or even by mail; and even if the website never works, Yglesias says it won’t make the ACA “unworkable” anymore than an absence of a website made Medicare “unworkable” in its earliest days.

What really makes the ACA “more than a website” is how it’s already working for many Americans.

Who Is It Helping?

  • CNN iReport contributor teachkjg wrote in September that health care reform probably saved her son’s life. Isaac was born without a complete esophagus, and spent 11 of his first 13 months in the hospital, undergoing 14 major surgeries. The family brought Isaac home when he was 13 months old. One month later, Isaac’s health insurance was cut off.  At 13 months, he hit the $2 million lifetime cap on his insurance. Isaac’s parents (who work full-time) wondered how they would pay for his care. One month later, health care reform became law. Now, Isaac can no longer “max-out” his coverage, and he can’t be denied coverage due to his pre-existing condition.
  • As a college freshman, Aqualyn Laury suffered a stroke due to a tumor in her heart. She had open heart surgery to remove the tumor, and repair a damaged heart valve. Fortunately, she had insurance through her mother. In 2005, Laury started her own business. Later that year — after emergency gall bladder surgery, and complications due to a blood clotting disorder —  Laury’s insurer dropped her. She was stuck with $50,000 in medical bills. After the ACA passed, Laury qualified for her state’s Pre-Existing Condition Insurance Plan, created as a bridge until ACA coverage began. Soon after, Laury suffered a heart attack. Thanks to the ACA, she was covered, even when an allergic reaction to treatment extended her hospital stay to a week. Laury believes having coverage through the ACA saved her life. “Otherwise the stress of having no coverage during my heart attack may have contributed the final, fatal blow,” she said.
  • Last fall, Daily Kos’ SiliconKossack (SK) went in for a routine colonoscopy, and learned that he had an unusual number of polyps. His doctor said a total proctocolectomy might be necessary, and advised him to get a genetic test to determine whether he had a type of familial polyposis with a near 100% risk for cancer. “Two years ago I would not have advised you to get a genetic test, the doctor said. “But with Obamacare, now you can’t be denied coverage if you change jobs. Otherwise, I would have been afraid to even suggest this.” SK got the testing done, and his doctor’s original hypothesis was correct. He went on to have the necessary surgery. SK writes: “If I had not had this second set of tests, I would have definitely delayed any surgery, as I was feeling fine. But thanks to Obamacare, I got the additional tests that I would have never known about. Like many thousands of men who die from colon cancer, I would have likely avoided getting treatment for what seemed to be a minor problem.”
  • At 26, Jennifer Sky experienced a sharp pain in her right side that lasted for hours. Her husband drove her to the emergency room. Twelve hours of testing revealed that non-cancerous tumors were taking up half her liver. At any moment, blunt trauma to her abdomen could have caused her to bleed to death. Doctors eventually removed a football-sized tumor. After they separated, Sky continued to have coverage through her husband’s job, until a manager’s “irreversible filing error” led her to be dropped “retroactively,” and stuck with tens of thousands of dollars in treatment that wasn’t covered. “Please, I’m sick, I can’t lose my insurance,” she begged the insurance representative on the phone, to no avail. When Sky tried to apply for insurance, she was denied. Now, thanks to the ACA Sky has coverage and can’t be denied due to her pre-existing condition.
  • Without health care reform, John Grooms says he’d either be dead or buried under medical debt. After leaving his full-time job, Groom’s continued his coverage through COBRA. A few months later, he was diagnosed with bladder cancer. It was caught early, and COBRA covered most of the cost of treatment. Six months later, after a recurrence, Grooms’ urologist recommended a preventative procedure. But COBRA coverage would run out before he could begin the procedures. So Grooms decided to “wait and see.” In 2009, his symptoms returned. He looked for insurance, but most insurers wouldn’t cover him, and the only one that did would have charged him $1,500 per month for a “half-assed” plan. After the ACA, Grooms joined his state’s insurance pool for people with pre-existing conditions, got insurance at a far better rate, and got the treatment he needed.
  • In 2001, 57-year-old former trucker Kenneth Hobby was diagnosed with lymphoma and treated with chemotherapy. After the cancer went into remission, an abscess caused him to have his right leg amputated. Hobby had been on and off Medicaid in recent years, and was in a program scheduled to expire at the end of October. A Family Health Centers Kynect application counselor helped get Hobby signed up for Kentucky’s health care exchange.  “I,m thrilled knowing that I’ll have insurance — finally — for 12 months out of the year,” Hobby said, “If I had two legs, I’d be doing cartwheels.”
  • Andrew Stryker, 34, struggles to pay a $600 monthly premium for the COBRA plan from a job he left a year ago. He has high blood pressure, and says insurance companies have denied him coverage as a result. It took Stryker three hours to purchase health insurance through the new ACA website, but he found a plan that would save him a lot of money. “Obviously three hours is a long time to wait,” Stryker said, “but it will save me over $6,000. For that, I would have waited all day.”
  • Janine Urbaniak Reid’s son, Mason, reached the lifetime cap on his health coverage by age 14. Mason was diagnosed with a brain tumor at 10. He spent six months in the hospital, 65 days in pediatric intensive care, and had 4 brain surgeries. Halfway through Mason’s hospitalization, the ACA passed. Eliminating lifetime caps on coverage saved his family from the financial abyss of soaring medical bills and bankruptcy. Health care reform also means that Mason will have insurance through his parents until he is 26-years-old, at which point he can purchase his own through an insurance exchange, and he won’t be denied coverage or charged an exorbitant premium due to a pre-existing condition.

Let Them Die

Urbaniak Reid’s story was one of the most-read pieces on the Washington Post website. Fortunately, she was warned against reading the comment section.

The only thing more striking than the commenters vehement opposition to the health care reform is their equally intense antipathy towards Urbaniak Reid and her family. Some were certain that there must be better ways to help families in similar circumstances. (Most — like depending on “charities or churches,”  assigned risk pools, or income tax credits for pro-bono medical care — would still lead to health care costs and/or taxes.) Others couldn’t care less if Urbaniak Reid’s son died, or her family was destitute.

Reading their comments would have disappointed the author, given the hope she expressed towards the end of her column.

As far as the brain tumor goes, our family might have drawn the short straw. Maybe our story lacks a certain universal appeal. People might thinking to themselves, “I’m so sorry that happened to you, but odds are it won’t happen to me.” I hope it doesn’t, really.

But having lived in hospitals with Mason for months, I have seen that bad things — accidents, freak illnesses — happen to smart, cautious and otherwise undeserving people. It’s one thing we all have in common. We are fragile beings. So what is wrong with allowing us to purchase a financial safety net? What’s so un-American about that? That question — “What’s so un-American about that?” — is going to be a problem for Republicans. Health care reform isn’t just a website, it’s a program that’s already helping people. As more Americans experience the benefits of health care reform, they may ask themselves the same question: What’s so un-American about this?

When that happens, support for health care reform will rise. Health care reform is already more popular than the GOP. According to a CNN poll, 53 percent of Americans either support the health care reform act, or say that it doesn’t go far enough. (In the same poll, 54 percent say it’s a bad thing that Republicans control the House.) A Washington Post/ABC poll shows that 66% of Americans want to see the law implemented.

The problem for Republicans is that they don’t have an answer that most Americans want to hear, because it hasn’t changed much since that GOP candidates debate in 2011: Let them die. That answer was reiterated by economist Tyler Cohen earlier this year, when he described what conservatives should put into health care policy: “We need to accept the principle that sometimes poor people will die just because they are poor.”

What’s So Un-American?

Last month, Republicans unveiled their long-awaited “replacement” for health care reform. It was a rehashing the same old Republican ideas Americans have already rejected: health care savings accounts, state-run high-risk pools, tax deductions for purchasing private health insurance, selling insurance across state lines, and “tort reform” in medical malpractice cases.

The GOP’s “replacement” doesn’t address rising health care costs, and doesn’t cover as nearly many people as the Affordable Care Act. Maybe that’s why Republicans have spent more time attacking health care reform than promoting their alternative.

Meanwhile, tens of thousands of Americans are getting health insurance who didn’t have it before. Many of the poorest Americans are getting health insurance. (But nearly 8 million of the poorest Americans remain uninsured — because of the 26 Republican-controlled states that have refused to expand Medicaid coverage.) Americans with any number of chronic conditions no longer have to fear lifetime coverage caps and medical bankruptcy. Americans with pre-existing conditions no longer have to fear being denied insurance, and left uninsured.

As Janine Urbaniak Reid asked, “What’s so un-American about that?”

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