By Todd Lassa
The Allegany County Day of Civility presents a Zoom debate by Braver Angels/Bridge USA and the American Council of Trustees and Alumni (ACTA) Thursday, April 8, beginning 7 pm Eastern time on the resolution; “Should government provide health care for all citizens?” The debate is organized by the Allegany College of Maryland and Frostburg State University, and is sponsored by Allegany County Choose Civility, the Allegany College of Maryland’s Peace Club, its Democracy Commitment Committee, the Frostburg State University Debate Team, FSU Communication Leadership Lab and The Hustings. You may register for the debate (free) at https://www.eventbrite.com/e/braver-angels-debate-should-government-provide-healthcare-for-all-citizens-tickets-146961278139 up to 6 pm Eastern time Thursday, and you are encouraged to participate.
This post is a preview of the debate, with affirmative talking points in the left column and negative talking points in the right column. Come back to this site Friday for a review post of the debate, and again on the weekend for a compilation of your comments. Instructions on how to comment are at the end of this column.
Theodore Roosevelt was the first president to seriously propose universal health care, toward the end, and again after his second term as president. Most Americans paid their doctors directly back then, although some union workers received health care benefits. The notion of government help or involvement did not make a serious political appearance until the Social Security Act of 1965 sought to cover the older and the poor with Medicare and Medicaid.
Universal health care advocates had to wait another 45 years — until 2010 – for any significant new legislation, when the Obama administration pushed the Patient Protection and Affordable Care Act (ACA) through a Democratic-majority Congress just months before Republicans won 63 House seats in the 2010 mid-terms. Though President Obama claimed the ACA was modeled on former Republican Massachusetts Gov. Mitt Romney’s health care reform program for his state, universal health care coverage had shifted from a fair degree of bi-partisan support to become a very polarizing issue.
“Obamacare” immediately was met with resistance by Republican governors, who declined the expansion in their states of Medicaid benefits to a wider spectrum of individuals, one of the key provisions the Obama administration designed to reduce the number of uninsured Americans, widely estimated at 40 million at that time.
Free-market opponents concentrated on the ACA’s “individual mandate.” If an individual did not have health insurance through an employer or provided by a union or other group, the individual was required to purchase insurance or face a federal penalty. Health care exchanges were to provide such insurance at reasonable prices for working class and middle-class Americans, but they depended on a large membership pool in order to control costs.
Conservative Republicans also tackled the ACA during the second Obama administration from a “culture wars” perspective. They scored a victory in Burwell vs. Hobby Lobby Stores Inc. (2014), as the U.S. Supreme Court ruled in favor of Hobby Lobby, 6-3, that a business owned by individuals with “sincere Christian beliefs” could not be compelled to include contraceptive services among its employees’ health insurance benefits (cited by the Legal Information Institute of the Cornell Law School).
Small businesses often do not include health insurance among their employees’ benefits; an organization of small businesses challenged the individual mandate in 2012 in National Federation of Independent Businesses vs. Sibelius. The Supreme Court upheld the mandate in a 5-4 vote (fact-checking source: Wikipedia). But Republican opponents were tenacious.
Even before he took office in January 2017, Donald J. Trump vowed to dismantle Obamacare and replace it with a “better” plan of his own (which failed to materialize during his four years as president). Meanwhile, the Republican-led Congress in its budget bill for fiscal year 2017 cut the penalty for failing to fulfill the requirement to have health insurance coverage to $0.
Two popular planks in the ACA that remain are the rule preventing health insurance companies from denying new customers because of “pre-existing conditions,” and the rule that requires employer-provided insurance to continue to protect the children of families covered up to age 26. Democrats used Trump’s promise to dismantle the entire ACA, and thus remove those provisions, as a cudgel in opposing his re-election last year.
While Republican plans to fully dismantle the ACA have faded since Trump’s loss last November, progressive forces on Capitol Hill led by Sen. Bernie Sanders, I-VT, (who caucuses with Democrats) continue to push for universal health care for the entire country. They argue that the richest country on Earth should offer free, single-payer health care for anyone in the U.S. and relegate private health insurance as a so-called “Cadillac plan” option for well-off Americans for elective surgeries and procedures and unlimited choice of providers. As a splintered GOP concentrates on more immediate matters, the moderate wing of the Democratic party, led by President Biden, promises to repair and update the ACA rather than completely starting anew as Sanders and his progressive colleagues would prefer.