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health insurance

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The health insurance reform bus tour, 2009.

At a time when it can feel like America's most pressing problems aren’t being addressed, there’s some very good news on the healthcare front that everyone should know. The percentage of Americans who are uninsured has hit the lowest point in American history.

A report from the Office of Health Policy earlier this year announced that the uninsured rate hit an all-time low of 8% in the first quarter of 2022. To give some perspective, in 2010, before the Affordable Care Act (ACAalso known as Obamacare) had been fully implemented, the uninsured rate was twice as high at 16%.

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Since he first ran for the presidency, Donald Trump has been on a mission to destroy the Affordable Care Act, aka Obamacare. Whether he attacks the plan that made health insurance available to more than 20 million Americans because he genuinely understands it and doesn't like it or because it's something that Obama did is unclear, but either way, getting rid of it has been on his agenda for four years.

(Now might be a good time to remind people that the bones of the Affordable Care Act were built by Republican Mitt Romney, whose Massachusetts healthcare reform during his time as Governor served as a model for Obamacare.)

Trump's promises to take down Obamacare have been accompanied by promises to replace it with something better. After all, if you take away a healthcare law that protects people with pre-existing conditions and makes health insurance available to millions who couldn't afford it, you have to put something in its place or you literally put people's lives at risk.

The president appears to know this, because he keeps saying he's got a healthcare plan coming. The best healthcare. The most tremendous healthcare. Fantastic. Terrific. A big, beautiful plan the likes of which the world has never seen before. And it's coming soon. Very soon. So very soon. Within two weeks, he's said several different times, many months apart.

Biden pointed out at last night's debate that Trump has no plan for healthcare, and Trump again repeated what he's been saying since at least January 2017. The Lincoln Project compiled these claims in one video, and even though we've heard them before, it's striking to see almost four years of promises condensed into a minute and fifteen seconds.


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I got married and started working in my early 20s, and for more than two decades I always had employer-provided health insurance. When the Affordable Care Act (ACA, aka "Obamacare")was passed, I didn't give it a whole lot of thought. I was glad it helped others, but I just assumed my husband or I would always be employed and wouldn't need it.

Then, last summer, we found ourselves in an unexpected scenario. I was working as a freelance writer with regular contract work and my husband left his job to manage our short-term rentals and do part-time contracting work. We both had incomes, but for the first time, no employer-provided insurance. His previous employer offered COBRA coverage, of course, but it was crazy expensive. It made far more sense to go straight to the ACA Marketplace, since that's what we'd have done once COBRA ran out anyway.

The process of getting our ACA healthcare plan set up was a nightmare, but I'm so very thankful for it.

Let me start by saying I live in a state that is friendly to the ACA and that adopted and implemented the Medicaid expansion. I am also a college-educated and a native English speaker with plenty of adult paperwork experience. But the process of getting set up on my state's marketplace was the most confusing, frustrating experience I've ever had signing up for anything, ever.

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It's no secret that the way healthcare is handled in the United States is a mess. We are the only developed nation without guaranteed universal healthcare coverage. We tie health insurance to employment, which is silly, and we pay far more than citizens of any other nation for medical care that doesn't even result in great outcomes. Even the Affordable Care Act, which helped people who previously couldn't be insured get insurance, comes with a high cost in certain states.

When I talk to people in countries with universal healthcare, they're often baffled by the inane way our system works. But my favorite part is when I tell them, "Wait til you hear about COBRA."

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