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Amy Fried is a retired political science professor at the University of Maine. Her views are her own and do not represent those of any group with which she is affiliated.
If the Affordable Care Act, also known as Obamacare, hadn’t passed, some people like me wouldn’t have been able to get cancer treatment.
Back in 2013 I had surgery for what several oncologists told me was likely ovarian cancer. Luckily the tumors turned out to be less dangerous. But in the fall of 2022, I found out that, as happens about 15 percent of the time with my situation, my borderline disease became cancer.
I’ve had chemo and other treatment and luckily my cancer is now under control.
The ACA’s passage 14 years ago marked a huge improvement for people with cancer. Before then-President Barack Obama signed it into law, insurance companies could deny coverage for pre-existing conditions.
Insurance companies also could cap the amount they paid annually or over a patient’s lifetime. If bills went over the cap, patients and their families would have to pay the rest of the cost. Jettisoning caps has made cancer treatment much more affordable.
The ACA also enabled young adults to stay on their parents’ insurance. After a young woman I know was diagnosed with a brain tumor, her father told me “Thank God for Obamacare.”
According to the last government report, 92.3 percent of Americans have health insurance coverage, the most in U.S. history and a huge improvement since the ACA was enacted. It would be even higher if 10 holdout states expanded Medicaid, something the Supreme Court made optional. Reversing Gov. Paul LePage’s decision, Gov. Janet Mills did so and Maine’s uninsurance rate fell to 6.5 percent in 2022.
We’ve stopped the steady increase in health care costs as a percentage of the gross domestic product, except for a 2020 pandemic spike that’s since dropped.
Along the way, the Affordable Care Act became rather popular, going from being supported by four in 10 Americans 13 years ago to six in 10 now.
Still, former President Donald Trump, who tried to repeal Obamacare, said he’d try again if he’s elected in November.
In contrast, President Joe Biden lowered insurance costs with premium support and is, with support from Congress, decreasing prescription drug costs for the elderly, limiting out of pocket costs and negotiating with drug companies. Biden proposed expanding these for all Americans.
Last week House Republicans put out a plan with health care cuts; it also would raise the Social Security retirement age, so older people, who have more chronic conditions, would have to work longer or get lower benefits. Biden opposes all that.
There’s more to do on health coverage. We need to tackle insurance company decisions requiring pre-authorizations for treatment that delay or restrict treatment. We need to limit costs, especially for people without good private insurance, Medicare, Medicaid or premium support. We should move toward universal coverage.
It’s also essential to protect reproductive care. Since the U.S. Supreme Court’s Dobbs decision, abortion has been heavily restricted in many states, while some, like Maine, have expanded and protected access.
Oral arguments in the Supreme Court were scheduled for March 26 for a case that could ban an abortion medication, Mifepristone. It’s safe and effective, is used early in pregnancies and can be prescribed via telemedicine. Since 63 percent of all abortions involve medication, limits would make it harder for women to control their reproduction.
And even if the Supreme Court leaves medication abortions alone, they’re threatened by a Trump presidency, since anti-abortion groups have plans for Trump to issue executive orders swiftly to take the drug off the market and impose related policies.
The Heritage Foundation’s Project 2025, the House’s Republican Study Committee and others also would restrict IVF and birth control. Some leaders in this movement oppose sex for pleasure (as opposed to procreation). Chris Rufo criticized “recreational sex.” Randall Terry called contraception “anti-child,” a striking comment given that 90 percent of American women have used birth control and 86 percent have children.
In contrast, Biden wants to bring back national abortion rights and would sign a law doing so, and he backs IVF and birth control.
Obamacare passed because the American people voted, people mobilized in their communities and the executive branch and Congress acted. I know it’s helped people like me who have cancer and other serious diseases. The ACA and other health programs should be continued and improved even more.
