Senator Green: Improve Obamacare, don’t repeal it

Hawaii has long been a health care leader.

In 1974 the landmark Prepaid Healthcare Act was passed by the Hawaii Legislature enabled us to insure most of our citizens by mandating that any working individual (more than 20 hours per week) received employer-sponsored health insurance.

Since that time, Hawaii has consistently ranked as the state with one of the lowest uninsured rates, usually hovering around 9 percent. We in turn have been continuously ranked No. 1 nationally for almost all health outcomes.

We are the nation’s healthiest state.

Our low uninsured rate has meant access to health care when people need it most. If citizens need to go to the emergency department, they are covered. Our people receive cancer screening at better rates than any other state in the land. We provide prenatal care to all of our young mothers who ask for it. When our seniors need help at a nursing home the service is available.

Our vaccination rates are among the highest in the country and though we have well documented challenges regarding health care provider shortages (especially in rural areas of Hawaii) we still find a way to get people care more effectively than our peers across the country. We are doing a better job delivering health care in Hawaii than the other 49 states.

We’re now witnessing from afar, the health care debate in Washington, D.C., which proposes to repeal and likely replace the Affordable Care Act, also known as Obamacare. This proposal from the Republican-led Congress, supported by President Trump, would radically roll back the health care safety net as Americans know it.

It proposes almost $1 trillion in cuts to the Medicaid health care safety net over the next decade. Hawaii alone would lose over $200 million a year in healthcare support for our people, $2 billion over 10 years.

Specific cuts could be even more profound than the global reductions, such as shrinking or eliminating resources to treat those suffering from opioid addiction. Opioid use is at a national all-time high and has recently been described as the crisis of our time by many, with as many as 10 percent of the U.S. population experiencing some form of addiction.

In Hawaii we are already only able to provide addiction treatment to less than 5 percent of our addicted love ones. The new bill may make it impossible to treat almost anyone with addiction, using Medicaid dollars.

One draft of the current legislation proposed to totally defund women’s health care services, provided at Planned Parenthood. This is often an attempt to insert the debate about a woman’s right to choose into a more global question of access to healthcare. It is despicable to divide us in this way.

When Obamacare was passed into law in 2010 it enabled states like ours to provide health insurance coverage for many more of our people. In Hawaii we were able to expand our Medicaid program from 252,000 low-income citizens to approximately 362,000 covered individuals. This lowered our uninsured rate to below 4 percent.

From a practical standpoint this meant that more than 100,000 additional Hawaii residents had the coverage they needed for their families, especially children and adults with chronic illness. It meant that people didn’t have to choose between paying rent and paying for health care visits. It meant people could stop worrying about going bankrupt if they had a healthcare crisis in their family.

It meant a young mother didn’t hesitate to bring her child to see me in the ER when her keiki had an asthma attack or an ear infection or perhaps something much more serious like leukemia. Obamacare meant we could breathe easier as a society when things got tough for our family’s health.

Having a higher percentage of our population insured also has meant greater stability for our rural hospitals. We have witnessed a great strain on the health care system with increasing chronic disease and an aging population, but this has been supported by having almost all of our citizens covered by health insurance.

If the current health care proposal passes it will not only force as many as 100,000 Hawaii residents to again become uninsured, but it will also put our health care safety net, especially the rural hospitals and health centers into grave jeopardy. Independent physicians will be less able to work in areas that aren’t densely populated or have too many uninsured people.

It will be a disaster. This will occur all across America and it makes one wonder why this proposal is even being considered in the first place.

Experts across the country in health care policy, including myself, agree that Obamacare needs to be updated, repaired and supported in a way that it can be more sustainable and continue to offer health care peace of mind for Americans.

Repealing it is not the answer — instead improving it makes the most sense.

In many regions across our country, including Hawaii, where there are too few insurers to provide health care plans provided for by the Affordable Care Act, we should allow people to choose a public option. This would be a very straightforward way to stabilize Obamacare. It would also set the stage for grand discussion about the merits of Medicare for All, should our healthcare system further fragment in an unstable way going forward.

Congress should have the courage to challenge big Pharma and demand that all medications for people become much more affordable. Congress should put aside its petty partisan bickering and realize that good health care for all of its citizens is good politics.

Congress should acknowledge that pre-existing conditions must be covered. Congress should guarantee that anyone with addiction gets a second chance. Congress should never tell a woman what to do with her body.

Congress should scrap this bad bill and make simple straightforward adjustments to improve Obamacare. Congress should make sure that our families have affordable health insurance, good doctors and nurses available 24/7 and a health care system we can all be proud of.

Perhaps they need look no further than Hawaii and our model to lead the way.

Senator Josh Green represents Hawai‘i’s 3rd Senatorial District and has served in the Hawai‘i State Senate since 2008. Green was elected to the Hawai‘i State House of Representatives in 2004 and served two terms, spearheading the movement to provide affordable, and accessible quality healthcare for all the people of Hawai‘i. Senator Josh Green currently serves as chair of the Committee on Human Services. He is a member of the Committee on Hawaiian Affairs.