It's almost unthinkable that five people, meeting behind marble columns in their private chambers, could decide the fate of 32 million ordinary Americans without health-care coverage, but that's what happened Thursday in Washington. And it turned out better than many expected with a 5-4 Supreme Court ruling upholding President Obama's signature legislative achievement.
I suppose the court's decision does not carry significant personal weight for the four justices in the minority who have probably never lived without health-care coverage in their adult lives. But for many Americans like myself, these issues are all too real.
As a self-employed writer, I've lived with and without health insurance over the past decade, depending on what my budget and finances would allow. I watched the cost of my personal health-care coverage rise from $200 a month in 2001 in Washington to $600 a month only a few years later in New York City.
I've seen young friends struggle with life-or-death health care decisions without access to a physician and others literally bankrupted by health care bills they couldn't afford to pay. I've known African-American women with diabetes who had no money to see a doctor and gay men afraid to take an HIV test because they didn't have insurance if the results were positive.
This is not the way it's supposed to be in America, in the richest and most powerful country on the planet. We're better than this.
All that started to change when Obama signed the Affordable Care Act in March 2010. The law expands health care coverage to 32 million Americans, prevents insurance companies from denying coverage to people with pre-existing conditions and allows young adults to stay on their parents' health-care plans until they turn 26. It also requires insurance companies to provide easy-to-understand benefit summaries, rewards small businesses with tax credits and gives subsidies to low-income people to help them buy coverage.
Even those with health-care insurance will benefit with lower premiums over time and the elimination of lifetime caps that insurance companies use to deny coverage when your costs get too high. And after all that, the reform will actually reduce the federal deficit by $143 billion, saving money for the taxpayers.
So why isn't the law more popular?
Some of the criticism has come from the left. Many progressives wanted a single-payer system like Medicare or a "public option" that would allow consumers to purchase insurance directly from the government. Instead, the Affordable Care Act uses a mechanism of exchanges to help drive down insurance costs and requires everyone who can afford it to purchase insurance or pay a penalty. This so-called individual mandate was originally a Republican idea, until Obama endorsed it as a way to seek compromise and make progress.
The health-care law is not perfect, but it's still far better than the largely unregulated system we had before. While some on the left may want more, the attacks from the right have been downright dishonest.
Although 67 million people voted for President Obama in 2008 knowing he wanted to implement health-care reform, Republicans have pretended he had no authority to push for legislation that most Americans initially said they wanted. After the law passed, fearful Democrats ran away and failed to defend it while opponents spent nearly a quarter of a billion dollars attacking health care reform in television ads. Never in my life have I seen so much inaccurate information and deliberate distortion about one issue as I have about health care reform.
Cynical political operatives put up smokescreens of misinformation about abortion, illegal immigration, death panels, socialism and a government takeover of medicine. They created waves of confusion to prey on the fears on innocent and ill-informed Americans. And yet they provided no alternative for what they would do to fix the broken health care system.
Now it comes down to two men. One, President Obama, staked his entire presidency and his reputation on a critical piece of legislation that simply tries to help people in need. The other, Mitt Romney, once supported a nearly identical health care reform law in Massachusetts and argued it should be a model for the nation, but now campaigns on repealing "Obamacare."
For a man of Romney's immense wealth, access to health care has never been a personal challenge. But for many ordinary Americans, even those with insurance, we remain one health care tragedy away from financial ruin. Now, finally, we can start to have some peace of mind.
Regardless of where you fall on the political spectrum, that's a big deal.
Keith Boykin is a New York Times best-selling author and former White House aide to President Clinton. He attended Harvard Law School with President Barack Obama and currently serves as a TV political commentator. He writes political commentary for BET.com each week.
The opinions expressed here do not necessarily reflect those of BET Networks.
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