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Photo courtesy of the office of State Senator James Sanders, Jr.
Photo courtesy of the office of State Senator James Sanders, Jr.

BY STATE SENATOR JAMES SANDERS, JR.

My friends, picture this – Senator John McCain, sick with brain cancer, standing on the senate floor in order to give the Obamacare repeal a thumbs down. It was an unforgettable image, especially for me, to see a fellow veteran take such a stand. His vote, along with those of Republican Senators Lisa Murkowski and Susan Collins, and the Senate Democratic caucus, defeated Republicans’ latest attempt to dismantle Obamacare. This bill aka the “skinny repeal,” was a narrow, final bid to repeal only Obamacare’s individual mandate.

Trump, of course, is used to losing control of Congress. In spite of his pushing, Republicans have passed no major legislation since his election, unless we count the appointment of Neal Gorsuch to the Supreme Court. In health policy, and elsewhere, Trump’s last resort is to fall back on the President’s law enforcement powers. Unfortunately, even that could put him within striking distance of severe damage to Obamacare. The “skinny repeal” would have forced insurers out of the private market and kicked millions off insurance, and the President’s enforcement-based options could do just as much.

Actually, he can choose not to enforce Obamacare’s individual mandate – skinny repeal without a vote. Under those conditions, the young and healthy would not be forced to buy insurance plans, steering the market towards the old and sick and driving up the price of insurance for everyone. He could also withhold subsidies paid to insurance companies to help them cover unprofitable plans, a move that would force many insurers off the exchanges. Finally, Trump could fail to fund outreach and advertising efforts, again resulting in fewer healthy and young people buying insurance.

These policies would put local health coverage in disarray. Here in New York State, the uninsured rate has gone from 10% to 5% in four years thanks to Obamacare – a small miracle. The vast majority of that increase has come from enrollment in Medicaid, but the Obamacare exchange markets are essential to the economy of Southeast Queens. Here, many people are self-employed, entrepreneurs, contractors, freelancers, or, they earn middle class wages from small employers who are not required to offer coverage. The exchange market is their best chance to access quality and affordable healthcare.

It appears that President Trump doesn’t care that people will lose coverage, and moreover, he doesn’t know how health insurance works, as he revealed in a recent interview. He sees health insurance as no more than a ball in a political game. We need a government by adults and for adults, the sort of government three Republicans and 48 Democrats voted to bring back last week.

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