It’s our position that expanding insurance coverage to all Americans is a crucial step. The passage of the Affordable Care Act ushered in exchange plans and federal funds for states to expand Medicaid coverage. We need to build on those successes.
Making sure every American has proper health insurance has been the goal of many presidents. The fact that about 10% of Americans remain uninsured and another 10% or so are under-insured (i.e., can’t afford their OOP costs) is tragic for every person who finds themselves unable to afford their care or finds their lives derailed by ruinous medical debt.
Solving the uninsured problem is hard. In some cases, it’s intertwined with other social ills like homelessness and mental health challenges, and in other cases it’s a matter of convincing or mandating that healthy working people pay for insurance even if they think they don’t need it. It may require additional subsidies. Finding the right cut points for subsidies where a family can be expected to pay for premiums may seem difficult, but we already have a system that forces those with incomes above certain thresholds to pay taxes or face prosecution and even jail. And mandatory insurance premiums are essentially taxes. So just as no family or individual above a certain income can avoiding contributing to schools, police departments, fire departments and the military, neither should people be able to avoid contributing to our healthcare system when, inevitably, they will benefit from it. If not directly, then through the spillover of enjoying an economy run by a healthier workforce.
The fact that there are inefficiencies and problems with our healthcare system is not justification for some people to refuse to contribute to it by claiming that paying for health insurance is merely a choice. (Again, schools, libraries, and the police have problems, and yet we fund them.)
To be clear, we aren’t calling for a single payor system. There is a profound benefit to society when businesses and organizations compete for revenue. A single plan would be a monopoly (and monopsony!), and consumers are right to fear that. We need universal healthcare paid for by competing insurance plans. States like Massachusetts mandate that everyone who wants to drive have car insurance, and there are competing insurance companies to choose from. It’s only the need to compete for members that drives plans to think hard before they decide not to cover something that people would value. A single plan could just say “no” and people wouldn’t have the option to voice their displeasure by switching plans.