Security is rarely associated with healthcare policy. But at its core, that’s exactly what health insurance offers — protection. The multi-billion-dollar question is simple: How much are we willing to pay to safeguard ourselves, loved ones and the larger community from risk, harm and potentially death? The verdict is still out.
The epitome of healthcare security, like security in other policy areas, is having the ability to seek quality health care at an affordable price and for all — including individuals living right above or below the poverty line. It also means healthcare access is a norm. Doctor visits shouldn’t be relegated to exchanges in an emergency room or urgent care facility, but a means of preventive care — that freedom is true healthcare security.
Doctors visits shouldn’t be relegated to exchanges in an emergency room or urgent care facility, but a means of preventive care—that freedom is true healthcare security.
In 1965, the authors of Medicaid attempted to do just that by providing healthcare security to millions of Americans. Today, Medicaid has grown to become the largest health care program with 66 million participants and with the passage of Obamacare — formally known as the Affordable Care Act (ACA) — coverage has expanded considerably, which was a net positive for millions of African Americans who found themselves right above the eligibility requirements for Medicaid, but were still unable to afford healthcare. As a result, there’s been an overall decline in the share of adults without coverage and for African-Americans specifically, the uninsured rate dropped by more than a third.
However, despite those, gains COVID-19 is another reminder of the healthcare disparities that exist between African-Americans and white Americans in particular. Black Americans (11.7 percent) have a higher uninsured rate when compared to whites (7.5 percent). This number helps to explain why African-Americans have been impacted at a greater percentage than whites. Coupled with pre-existing conditions such as diabetes, asthma, and hypertension to name a few contribute to the lethality of COVID-19 in blacks when compared to whites.
Great expansion is needed, as advocated by Democrats and their presumptive nominee Joe Biden, and would be a significant step in providing coverage for more African Americans. However, that should not come at the expense of those 55.5 percent of African-Americans who use private health insurance when compared to 33.7 percent who rely on Medicaid or public health insurance.
This brings us to a consequential question, which political party has the best interest of the African American community as it relates to healthcare? Well, that answer is complicated. As illustrated above, the African American community isn’t a cookie-cutter community, a one size fits all solution won’t provide great coverage and in fact, could cause further harm. Frankly, economic standing will greatly determine how coverage should be granted, so it’s a combination of policy initiatives advocated by both Democrats and Republicans that would provide maximum healthcare security.
The debate surrounding healthcare between Democrats and Republicans ultimately boils down to what role the federal government should play, how expansive that role should be, and the sustainability of Medicaid.
As it pertains to Donald Trump, he’s instructed the Department of Agriculture to provide more than $1 billion to improve access to healthcare services for 2.5 million people in rural communities, which is beneficial to African-Americans living in those areas. He’s also expanded access to what is called Association Health Plans, which allows small businesses to pool risk across states, resulting in their ability to offer affordable healthcare through the business for employees. Despite those good things, it goes without saying Republicans have attempted to completely repeal the ACA, which wouldn’t be good for the 33.7 percent of African Americans who rely on public healthcare for coverage. This is an important thing to mention with the few positive steps listed above.
On the other side, former Vice President Joe Biden has a healthcare plan that focuses on building on the ACA. He proposes several interesting policy proposals that could benefit African-Americans such as giving Americans a public health insurance option like Medicare. Similarly to Medicare, Biden promises his plan will reduce cost (whether or not it actually accomplishes that goal is debatable); however, one thing it could do is drive up competition, which usually reduces cost. Biden’s changes would essentially force private insurance companies to compete against this new public option, which gives more choices for the consumer.
There isn’t a single policy prescription that meets the demands of African-Americans because as the data suggest, African-Americans vary as it relates to need, which ultimately translates to how we as a community are covered.
Biden also promises to expand coverage to low-income Americans. Though his campaign website is vague on how he’ll mandate states to comply with the federal government’s request, such a step would provide coverage to 16.9 percent of African-Americans who qualify for Medicaid but aren’t receiving it because their state opted out of the ACA. The most vulnerable African-Americans would greatly benefit from this expansion.
The debate surrounding healthcare between Democrats and Republicans ultimately boils down to what role the federal government should play, how expansive that role should be, and the sustainability of Medicaid. As the population grows so will the need for such safety nets, which means there has to be enough competition in the private market to keep prices low.
There isn’t a single policy prescription that meets the demands of African Americans because as the data suggest, African Americans vary as it relates to need, which ultimately translates to how we as a community are covered.
Republicans have a point about the sustainability of any publicly funded program, and from an economic perspective, it would be unwise to ignore having a balanced program to maximize the efficacy of coverage. However, Democrats also raise a legitimate point about covering vulnerable groups to assure that those at the end of the economic spectrum have the same healthcare security as higher-income earners.
All things considered, bi-partisan legislation that takes the best principles and merges them to form the best legislation would avoid creating a policy paradox and accomplish a laudable goal of covering more people, balancing Medicaid’s budget, and providing greater competition in the private market.
The biggest win is collaboration.
Shermichael Singleton is a Republican strategist, commentator and writer. Follow him on IG @shermichael_.
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