“If you like your insurance, you can keep it” has become something of a rallying cry for centrist Democrats amid their continued opposition to a desperately needed overhaul of America’s dysfunctional health care system.
This focus group–tested and reductive slogan has always suffered from the same, glaringly obvious problem: namely, that the status quo binds health insurance for millions of American workers (and their families) to their employment status — meaning those who lose their jobs are liable to see their coverage disappear as quickly as their paychecks. “Choice” and individual autonomy, as implied by its misleadingly effusive framing, are an illusion under a system that gives bosses sovereignty over ordinary people’s access to medical care.
Nothing could have underscored this point more strongly than the ongoing global pandemic and its devastating macroeconomic impact, which has already seen unemployment claims go off the charts as businesses shutter and regular commercial activity grinds to a halt. Unsurprisingly, unthinkable numbers of American workers have already lost their health insurance — with the Economic Policy Institute putting the figure at around 3.5 million in the last fourteen days of March alone.
Last week, a new report published by Lansing-based public health care consultancy Health Management Associates suggests that tens of millions of Americans may lose their insurance in the coming weeks, with the total number of uninsured ultimately spiking to an astonishing 40 million. The report’s model estimates that those receiving coverage through an employer “could decline” in the range of “12 to 35 million” when factoring in both workers and their family members, with those affected most likely to be in lower-income brackets. While its authors note that many will at least theoretically be able to enroll in Medicaid, limited operational capacity and a number of other factors are likely to create barriers to access, and as many as 5 million could still end up uninsured.
With Congress doing little to effectively halt the ongoing mass layoffs in its last coronavirus relief package, measures to aid those about to lose their health insurance are desperately needed. Nonetheless, talks between Democratic and Republican House leaderships show little sign of foregrounding anything sufficiently sweeping — with Democrats currently pursuing measures designed to make it easier for people to buy insurance and encourage states to expand Medicaid.
Unless much larger provisions are included in the next relief package, the human cost of America’s broken health care system amid growing unemployment will be incalculable. Though resistance to Medicare for All from corporate interests is bound to persist, the crisis is nevertheless making a more forceful case for Medicare for All than political rhetoric ever could. Public support for nationalized health insurance is also approaching record levels and seems very likely to grow in the coming months as the situation worsens. Only a universal system, free at point of use and extricated once and for all from the Wild West of employer-based insurance can ever provide the certainty and security people need, inside or outside the ongoing pandemic.
The coming weeks will make that tragically clear.